Public Authority Statutory Equality and Good Relations Duties Annual

Public Authority Statutory Equality and Good Relations Duties

Annual Progress Report 2015-16 Contact:

 Section 75 of the NI Act Name: Lynda Gordon 1998 and Equality Scheme Telephone: 028 3741 2643 Email: [email protected]

 Section 49A of the Disability As above Discrimination Act 1995 and Name: Disability Action Plan Telephone: Email:

Documents published relating to our Equality Scheme can be found at: www.southerntrust.hscni.net ‘About the Trust Publications’

Signature:

This report has been prepared using a template circulated by the Equality Commission. It presents our progress in fulfilling our statutory equality and good relations duties, and implementing Equality Scheme commitments and Disability Action Plans.

This report reflects progress made between April 2015 and March 2016 PART A

PART A – Section 75 of the Northern Ireland Act 1998 and Equality Scheme Section 1: Equality and good relations outcomes, impacts and good practice

1 In 2015-16, please provide examples of key policy/service delivery developments made by the public authority in this reporting period to better promote equality of opportunity and good relations; and the outcomes and improvements achieved. Please relate these to the implementation of your statutory equality and good relations duties and Equality Scheme where appropriate.

This is the 9th Annual Progress Report prepared by the Southern Heath and Social Care Trust’s Equality Assurance Unit the purpose of which is to demonstrate how the Trust has fulfilled its:  S75 Equality and Good Relations Duties under S75 of the NI Act 1998 together with the commitments in its Equality Scheme  as well as its Disability Duties as set out in Section 49A of the Disability Discrimination Order (DDO). This year’s report shows substantive progress in implementing the above duties which has brought about improved outcomes for the 9 S75 equality categories. The implementation of the Trust’s Action Based Plan is central to the implementation of the Trust’s Statutory equality and good relations duties. The content of this Plan was informed by an ‘Audit of Inequalities’ including prior engagement and formal consultation with a wide range of service users and organisations. This Action Based Plan includes measures that have the greatest impact on equality of opportunity and good relations and draws on best practice. A copy of the Plan can be seen in Appendix 1- along with a progress update.

Examples of Key Policy Development during the year under review include:

 Smoke Free Policy Following a public survey in November 2014 the Southern Trust made the decision to make all Trust facilities and grounds completely smoke free with effect from 9th March 2016. This development is in line with other HSC Trusts in NI. This policy initiative has been endorsed by the Minster for Health. During the year under review the Trust established a number of working groups to take forward various work stands in preparation for smoke free status by 9th March 2016. These groups included:  Smoke Free Steering Group - tasked with overseeing the entire process for becoming Smoke Free – Chaired by the Trust’s Medical Director  Policy Development Group – tasked with the development of a new Smoke Free policy for the Trust and using the S75 processes to inform the development of same  Communication/Signage Group – tasked with the development of an action and communications plan  Cessation Support & Training Group – with a focus placed on smoking cessation services and training.

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The Trust extended representation to service users, staff and Trade Unions to express an interest in becoming members of the above groups to inform the roll out of this important public health initiative. The Trust’s Medical Director, Richard Wright chaired the steering group and provided strategic leadership, direction and oversight in ensuring the effective and timely implementation of this policy initiative. Of note a site visitation was organised to the Western Health and Social Care Trust, during the current reporting period, to draw upon and learn from the experiences of Western Trust colleagues. This visit took place on 8th September 2015. In keeping with its commitments in its Equality Scheme the Trust undertook a detailed equality screening of this new policy paying due regard to the S75 equality and good relations duties, the disability duties and human rights obligations. The Trust gave a commitment in its equality screening as follows: As the implementation of the policy progresses and particularly in areas such as mental health, learning disability, palliative care, post-traumatic events, the Trust will closely monitor the impact of the policy. Where, as a result of monitoring, opportunities arise which would allow for greater equality of opportunity to be promoted, the Trust will ensure that measures are taken to achieve better outcomes for the relevant equality groups. The Trust will review its equality screening template accordingly. The Trust will also keep pace with research developments in relation to the use of vapour devices i.e. how this can make a positive contribution to health and wellbeing of the population and the overarching aims of the Trust’s Smoke Free Policy. NB: In keeping with the commitment in its Equality Scheme the Trust’s completed screening template will be made available in its Quarterly Screening Outcome Report - which is uploaded to the Trust’s internet in the interest of openness and transparency. See also section 11 of this year’s report for the outcome of survey results on the proposal to go smoke free.

Staff pictured above at the official Launch of the Trust’s Smoke Free Policy

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To pave the way for the successful roll out of the policy a comprehensive communication strategy was drawn up and actively promoted. The rationale for this important policy initiative was also discussed at the Trust’s Race Equality Forum on 16th October 2015. Promotional materials were subsequently translated into a range of ethnic minority languages for sharing and dissemination amongst local BME communities.

A representative from the Trust’s Health and Wellbeing Team also attended a Regional Interpreter Stakeholder event (in the Medical Education Centre, Craigavon Area Hospital) on Monday 22nd February 2016. With over 300+ quality assured interpreters on the regional bank (who frequent the Trust’s sites on a daily basis) this presented an ideal opportunity to engage interpreters to play an important role as a conduit/catalyst in getting important messages out amongst black and ethnic minority communities re the intended aims of the Trust’s Smoke Free Policy.

Of note a legal challenge was presented to the South Eastern Trust following the go live date. The challenge was raised by an inpatient on a mental health ward a 23-year-old woman currently detained on an acute psychiatric ward. Lawyers for the woman at the centre of the court challenge claimed there was a failure to carry out proper consultation. They also contend that it amounted to a form of discrimination against a patient who was unable to leave. Granted anonymity in the case, the woman was being detained for up to six months at a hospital in the South Eastern Trust area. Her application for judicial review was aimed at security an exemption for those in her position.

It was confirmed on 21st April 2016 that a resolution had been reached, with the South Eastern Trust agreeing to review its decision to implement the smoke free policy in its acute mental health inpatient wards and environments. With the process set to take a minimum six-month period, the blanket ban will not apply to those hospital areas during this period. Counsel for the Trust confirmed that the South Eastern Trust will examine the process to ensure all concerns expressed are addressed. Dismissing the judicial review challenge on that basis, Mr Justice Maguire awarded legal costs to the woman who took the case.

Southern Trust staff met, as did other HSC Trusts, to review the outcome of this decision; took further advice from the Directorate of Legal Services; reviewed their respective equality screenings to ensure that sufficient evidence could be demonstrated of meaningful engagement with this particular group of patients; and considered any implications the outcome may have for the future roll out of their Smoke Free Policies.

Whilst upholding the overarching policy aims the Trust will, where deemed necessary and appropriate, exercise discretion in the practical roll out of the policy in areas where there are cogent and legitimate risks to the health and safety of the patient and staff. To be managed on a risk assessment and case by case basis.

The Trust also responded to a number of queries in relation to the practical implementation of Trust’s Smoke Free Policy during the currently reporting period this related to e.g. staff smoking off site and particular issues raised in relation to

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clients with a learning disability and acquired brain injuries and their ability to comply with the Policy aims.

The Trust will continue to support patients, managers and staff in meeting the objectives of this policy and will continue to monitor the practical out workings of the policy in all areas and specifically areas such as mental health and learning disability, trauma, palliative care and will take cognise of the outcome of the review in the South Eastern Trust.

 Gender Equality Research Joan Ballantine

The Trust’s former Chief Executive, Mairead McAlinden, the Director of Human Resources and Organisational Development, Kieran Donaghy and the Trust’s Head of Equality, Lynda Gordon participated in this important piece of research led by Professor Joan Ballantine, from the University of Ulster Jordanstown. The research was aimed at investigating a number of gender equality issues at executive/senior managerial levels which may affect an individual’s career aspirations to reach a senior position within the public sector. The research findings, funded by OFMDFM, were launched during the current reporting period at the Long Gallery, Stormont Buildings on 24th March 2016. The Trust’s Head of Equality was in attendance. Notable amongst the findings:

Organisations with a female Chief Executive or Chair employ greater numbers of female executives and non-executives at board level.

There follows a summary of some of the key findings:

Gender Composition for Executive Director and Non-Executives by Organisational Type

Organisation Type Female Male Senior Civil Service Executive Directors 26.5% 73.5% Non-Executives 32.5% 67.5% Local Government Executives Directors 32.8% 67.2% Non-Executives 23.1% 76.9% Non Departmental Bodies Executives Directors 28.9% 71.1% Non-Executives 27.6% 72.4% Health and Social Care in NI Executive Directors 44.4% 55.6% Non-Executives 46.2% 53.8% Further & Higher Education Executive Directors 35.8% 64.2% Non-Executives 31.4% 68.6%

NB: The breakdown of male to female senior managers in the SHSCT i.e. Band 8a and above was 40% Male and 60% Female figures. (Figures as at 13 May 2016). The ratio of male to female non-executives is currently 3 males to 5 females.

Females when compared to males identified a number of barriers to career progressions: Lack of recognition for work-life balance, lack of awareness of organisational politics, having to perform much better than males and continually

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prove themselves, having their ideas challenged more often and being judged more critically than males.

Significant benefits of gender balanced board were reported in terms of:

Facilitating different perspective or points of view; changing or moderating behaviour, incorporating softer skills into decision making; being representative of population served; facilitating more deliberate, collaborative and careful decision making.

For details of key recommendations emanating from this survey please refer to the notes of attainment – Trust’s Action Based Plan – action number 35 refers – Appendix 1.

 Human Rights Inquiry - launch of the findings As previously reported the NI Human Rights Commission launched a human rights inquiry into emergency care. This was the first time that emergency care had been the subject of a human rights inquiry. The inquiry was wide-ranging taking evidence from Ministers, the Department of Health, the Health and Social Care Board, Health and Social Care Trusts, clinicians and trade unions, key voluntary organisations, etc. A series of public hearings took place across Northern Ireland. The Southern Trust participated in two public events – in Newry and Armagh. The inquiry made a further call for evidence from the HSC Trust Equality Managers at hearings in Omagh and Belfast in 2014. The inquiry sought to use international human rights standards including the right to health as a lens through which to view emergency department health care e.g. the right to respect for dignity, responsiveness to need particularly among the most vulnerable and marginalised in society, participation and the involvement of people in receiving care and treatment. The inquiry also considered the provision of appropriate information for those recieving emergency care. The Panel of Inquiry included Chief Commissioner Les Allamby, Commissioner Marion Reynolds, assisted by Professor Paul Hunt, the former United Nations Special Rapporteur on the Right to Health. The Commission published its final report and recommendations to the Northern Ireland Executive in April 2015 and the report was formally launched in May 2015 and was attended by HSC Trust Equality Leads. In total there were 26 recommendations from this inquiry many directed toward the DHSSPS, notably the DHSSPS should develop dedicated Emergency Departments (EDs) minimum care standards, rooted in human rights thereby providing a benchmark for patient experience within EDs. Further, it was recommended that the HSCB and one or more HSC Trusts should pilot and evaluate a human rights based approach to care in EDs. Work on the pilot has been ongoing through the current reporting period between the Belfast Trust and the NI Human Rights Commission – learning from this will be shared across the wider HSC family of organisations.

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One of the recommendations in the Northern Ireland Human Rights Commission’s report into Emergency Health Care (published in May 2015) was that “the Health & Social Care Board (HSCB) should develop a regional protocol to reduce the incidence of, and to deal with persons who leave EDs untreated and subsequently become categorised as ‘missing persons”. In response to this particular recommendation guidance has been developed jointly by the HSCB and PSNI in collaboration with the Regional ED Clinical Engagement Group. This guidance was disseminated to HSC Trusts on 1st July 2016 for circulation to appropriate staff for implementation.

In preparation for implementation a joint HSCB/PSNI information session for ED staff was being planned.

Review of Trust’s Equal Opportunity Policy Statement

A review of the Trust’s Equal Opportunity Policy Statement was undertaken during the current reporting period to ensure that it is in keeping with best practice and important case law developments. The Trust’s policy is aimed at promoting equality of opportunity, eradicating unlawful discrimination and upholding the merit principle in terms of appointment, advancement and access to training and development opportunities et al within the organisation. In keeping with the Trust’s Equality Scheme commitment the revised policy was subjected to equality screening – see the Trust’s Equality Screening Outcome Report for the period 1st April to 30th June 2016 for further details.

 Review of the Trust’s Work Life Balance Policy

The Trust has an extensive range of policy initiatives to help staff reconcile and balance their work life commitments.

This suite of policies was reviewed during the current reporting period to take account of legislative developments not least the right to request and the right to have requests taken seriously for changes to working patterns for all staff regardless of their dependant status.

The policy was previously updated to take account of the new shared parental leave provisions which extends the opportunity to both parties to share parental leave after giving birth and adoption. Government figures, released this year, revealed that there was limited uptake of shared parental leave i.e. 1%. The central aim of this provision is to enable both parents to take a shared role in bonding and bringing up their children.

At the time of completing this year’s S75 Annual Progress Report work was advancing in finalising a draft policy to bring together ‘other leave entitlements – paid and unpaid’ in order to provide clarify and consistency in the application of these arrangements across the Trust and to ensure fair and equity treatment. This policy will also be subjected to the S75 Equality Screening and consultation.

 Promoting Inclusive Workplace - Transgender Policy Following on from a regional workshop held on Tuesday 2nd June 2015 (attended

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by a wide range of stakeholders) this policy has now progressed to a final draft stage. The policy has also benefitted from input from Janet Corey, lead Consultant in the Gender Identity Service and June Turkington, BSO, Directorate of Legal Services.

1. Roundtable discussions with Trans groups, LGB&T forum members, staff and Trade Unions took place on 27th and 29th January 2016. An event also took place with the LGBT sector on 3rd March 2016 in UNISON HQ Belfast.

This policy is aimed at creating a workplace where the dignity of and respect for Trans people is protected and promoted and where Trans people feel comfortable to express their gender identity. The policy will now be reviewed in light of feedback received from the focus groups.

 Promoting Inclusive Workplaces - Regional LGBT Forum

The HSC LGB&T Staff Forum extended an invitation to staff and members of the public, during the current reporting period, to join with them on the Newry Pride parade which took place on Saturday August 22nd 2015.

Newry Pride celebrates the many positive changes for lesbians, gay men, bisexual and transgender people but recognises that exclusion still exists. The Pride parade offers an opportunity for staff to stand alongside LGB&T colleagues to continue to promote an inclusive workplace for staff, patients and families. A range of events were organised as part of the Pride festival which were open to all to get involved.

The Forum received a great response at its Craigavon hospital information stall. A stall was also organised at Daisy Hill canteen on Friday 21st August 2015 and was well supported by staff. In addition, Newry Pride received a lot of support from staff on the Trust Facebook and Twitter feed.

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Included amongst the wider festival events was an Information and Health Fair which took place on Thursday 20th August 2015 - coordinated by The Rainbow Project, the Newry Rainbow Community and Newry Mourne & Down District Council with many locally-based organisations (including the SHSCT) present to give information and advice on a wide range of health and wellbeing issues including, promoting positive mental health, the prevention of self-harm and suicide, cancer awareness, healthy eating, quitting smoking and many more topics.

A confidential sexual health testing service was available in the NRC Centre.

Forum members have also been promoting the elearning module www.lgbtelearning.hscni.net which counts towards KSF and professional registration.

The Forum is endorsed by all of the trade unions and Trust management with receives admin support from the Public Health Agency. For more information about the Forum or to join the confidential email list contact [email protected] You can follow the forum on twitter at @LGBT_StaffForum or www.lgbtstaff.hscni.net . Information and news is also posted on the Trust’s Intranet for staff to read.

 Promoting Participation - Trust Placement Policy The Trust’s Placement Policy acts as a bridge to employment and provides the opportunity for individuals to gain valuable work experience to equip them for future paid employment within the Trust and elsewhere. During the current reporting period the Trust facilitated 7 placements for people with a disability. These placements are very flexible and short term in nature (up to 6 months) dependent on the needs of the individual and host.

The Trust’s Placement Policy stands alongside the Trust’s volunteering scheme which also provides opportunities for persons with disabilities to volunteer within the Trust. In addition, the Trust also receives referrals directly from local schools and colleges. This policy is currently being updated.

 Promoting Participation - Young Persons in Transition from Care – Employability Project - positive action in employment

As a corporate parent, the Trust has made significant investment in supporting the education, training and employment needs of Looked After Children. This has been achieved through the introduction of an Employability Project which aims to provide young people within the 16Plus Leaving and Aftercare Service with support to enter and sustain education, training and employment opportunities within the Southern Trust locality.

The Trust recognises that for a variety of reasons young people, transitioning from a care environment wishing to obtain employment, require additional support measures over and above that which is currently provided. The Trust has therefore put in place a range of support measures to assist young people during the

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recruitment process and subsequently during their placement. Such supports include - assistance in completing application forms via a training session; assessment preparation; support in employment via comprehensive induction and a mentoring programme with the aim of helping young persons in meeting and sustaining the standards of behaviour and performance required.

A training and development plan is also agreed which enables the young person to reflect on their knowledge, skills and values in a structured way - with a focus on attaining the necessary knowledge and skills required for success.

The benefits of this project are significant, not only to the Trust in terms of its corporate responsibility but to wider society. The scheme seeks to ensure that these young people not only have the opportunity to start adult life in a positive manner but also have the opportunity to glean real and meaningful work place experience to help them in their search for paid employment with the Trust and elsewhere.

The Trust has worked closely with the Equality Commission for NI and has valued their input in the development of this scheme.

As of February 2016 - 81% of young people age 19 leaving care are in ETE (Education, Training or Employment) within the Southern Trust.  Celebration for young people in care

An awards event took place, during the current reporting period, to celebrate the successes of young people in care. The Southern Health and Social Care Trust in partnership with The Fostering Network hosted the event in Armagh City Hotel on April 12th.

100 young people in foster and residential care were nominated by their social workers and received awards for a wide range of achievements. Opening the awards ceremony, Paul Morgan, Director of Children and Young People’s Services in the Southern Trust said:

“We know the many challenges that young people in care face, so it is important to celebrate when they overcome these challenges and achieve success. As parents we are proud when our children do well, and as corporate parents for the children in our care - we in the Southern Trust are extremely proud of their achievements and want to celebrate them.

The young people here today have taken their future into their own hands, have excelled in areas of their individual interests and have gained knowledge and skills that will help them in the future.”

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Kathleen Toner, the Director of Fostering Network, commented:

“We are increasingly aware of the importance of the Fostering Achievement programme in supporting the aspirations of children and young people in foster care. Working with foster carers and kinship foster carers as primary educators is key to our success as are the close partnerships with education and health which enable us to provide individual support to more than 1300 children and young people each year. We are particularly delighted to be delivering our Achievement Awards in partnership with the Southern Health and Social Care Trust; this is prioritising the importance of education outcomes for looked after children. Education in its broadest sense is crucial to providing young people with the skills and knowledge they need to make choices to reach their full potential, we are very proud of the part we play in that.”

One care leaver, Aiysha Johnston, shared her own views on the importance of education when in care:

“Education is so important, sometimes we just don’t see it that way, if I had one message to give, it is this – use all the support available to you and stick with it because it is your future.”

 Mainstreaming S75 Equality Duties - Trust’s Equality Scheme

Pilot of Revised Screening Template

Discussions about the screening template have been on-going for some time between HSC Trust Equality Leads and the Equality Commission for NI. Much of the discussion has centred on the length of the screening form and its application where policies have little or no bearing on equality of opportunity or good relation i.e. policies which are clearly technical or clinical in nature. During the year under review the Trust’s Head of Equality together with other HSC Trust Equality Leads met with consultants engaged by the ECNI at Equality House in Belfast. The consultants were commissioned to undertake research into the experiences of public authorities in relation to S75 - notably equality screening and Equality Impact Assessment processes. HSC Equality Leads participated fully and frankly in the research and the discussion that took place. HSC Trust Equality Leads also completed an on-line questionnaire in relation to the research and brought to bear their collective experience of the out workings of the S75 duties. HSC Trusts are committed to working with the ECNI to support best practice in relation to equality screening and EQIAs. For now HSC Trusts continue to conform

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with the Equality Commission for NI existing guidance on Equality Screening and Equality Impacts Assessments – see this year’s recent example of a worked EQIA. i.e. ‘Proposal for the Future of Statutory Residential Care for Older People’ and associated consultation document- which received praise from the older persons sector for its standard of production and ease of way finding.

 Review of Equality Scheme and Action Based Plan HSC Trust Equality Leads plan to undertake a review of their existing Equality Schemes and publically consult on revised schemes during 2016/17 in preparation for the launch of new schemes and associated action based plans – to cover the reporting cycle May 2017 thru May 2022. These plans aim to tackle health inequalities and as before will be based on evidenced based research and cover all functions undertaken by the Trust including service design and delivery, procurement and employment. HSC Trusts are also mindful that the ECNI is to issue guidance, arising out of the implementation of the Fresh Start Agreement, in relation to consultation timeframes i.e. Clause 65 – ‘Engagement and Consultation’ refers. Essentially, Clause 65 is aimed at quickening the pace of policy development and decision making processes. The Fresh Start Agreement, whilst aimed at shortening consultation timeframes, will be predicated on a greater emphasis on sustained and meaningful engagement as a precursor to any public consultation. This guidance was expected to be issued to Public Authorities following the May 2016 elections. NB: At the time of finalising this year’s annual progress report the Commission reported that its “consultation exercise did not present a consensus for adopting the proposed amendment, and on balance more consultees were opposed to the change than in favour of it. Following consideration of the comments received, the Commission decided not to amend its advice as set out in the consultation document. The Commission confirmed that the advice will remain as it is currently, as an interim measure, pending a planned review of the Section 75 duties scheduled by the Commission during the coming three years”.

The situation is we now have 3 separate pieces of guidance:

 ECNI advocating 12 weeks for EQIA consultations – retaining the status quo  The Executive advocating 8 weeks maximum on policy consultations – Clause 65 Stormont House Agreement  DHSS Solicitor advocating “adequate time”

In cases where there are policy proposals being presented for consultation with the Equality Impact Assessment of those proposals, as recommended by the Equality Commission for NI ….a public authority can determine the appropriate application of its Equality Scheme commitments on consultation, including its timescale, in order to fulfill its statutory equality and good relations duties.

NB: The Trust’s Equality Scheme stipulates …a minimum of twelve weeks to allow adequate time for groups to consult amongst themselves as part of the process of

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forming a view. However, in exceptional circumstances when this timescale is not feasible (for example implementing EU Directives or UK wide legislation, meeting Health and Safety requirements, addressing urgent public health matters or complying with Court judgements), we may shorten timescales to eight weeks or less before the policy is implemented. We may continue consultation thereafter and will review the policy as part of our monitoring commitments.

Where a consultation has straddled a public holiday period it has often been the case that the Trust has extended its consultation period beyond the twelve week period to compensate for this fact.

Equality Screening Template

One of the proposed changes to the equality screening template is to augment it with a new Section 3 as follows:

Addendum to Section 3 - Equality Screening Tool

(3.1) Personal and Public Involvement (PPI) is about people and communities influencing the planning, commissioning and delivery of health and social care services. It means actively engaging with the public and those who use our services. Health and Social Care (Reform) Act (NI) 2009 Sections 19 & 20 require that service users and carers are involved in and consulted on:

1. The planning of the provision of care 2. The development and consideration of proposals for change in the way that care is provide 3. Decisions that affect the provision of care.

(3.2) Taking into account the information above (NB: Referring to equality screening template questions here) and the responses you have made in sections 1 and 2 of the equality screening template, please outline your involvement process in relation to this policy/proposal.

Method of When did How did this involvement? this influence the How did you Consultation happen? decision? recruit? E.g. workshop/ What changed patient/service information for user list, list of event, Trust/service Who did you involve? Number interested questionnaire users? people, existing 1:1 service user interviews, groups/forums, focus groups, advertising, planning group Service Users-past, present, future Carers Staff Staff side Community/Voluntary

PART A organisations General public MLAs etc. Patient Client Council Other please specify

Please also consider:  How will you evaluate the process?  How will you provide feedback to those involved?  Sharing the impact and learning

For further support and advice on completing this section of the screening template please contact: Carolyn Agnew, Head of Service User Involvement and Community Development 028 37412519 [email protected] Sinead Hughes, PPI Officer 028 37 412523 [email protected]

HSC Trust Equality Leads will also take into account the outcome of the evidenced based research commissioned by the Equality Commission for NI into the application of S75 processes i.e. equality screening and EQIAs and reflect any resultant recommendations as appropriate.

Budgetary Constraints – Programme for Government

The Trust (as with other HSC organisations) will continue to face ongoing pressures in terms of the current Programme for Government and associated budgetary constraints during this current financial year and beyond. As a positive step, and on the basis that the Trusts are best placed to fully understand the health needs of their local populations, Trusts have been provided with more flexibility to deploy their resources as they determine, in order to address those needs. This includes the ability to set savings targets at a local level, rather on a regional basis, as was previously undertaken by the HSCB. This will undoubtely impact on the way services are delivered and managed in going forward. The Trust will continue to pay due regard to its S75 Equality Duties as evidenced in the commitments given in its 3 year Strategy Plan ‘Improving through Change’ 2015-2018 and its Financial Plan for 2016/17. The Trust is also mindful of the Equality Commission's Guidance on S75 and Budgets in the discharge of its equality duties particularly in relation to equality screening, equality impact assessments as well as the need for cumulative assessements to be undertaken to inform decision making processes and the setting of budgets. The Trust will continue to ensure that the S75 equality duties are mainstreamed into decision making processes - mentionable examples include:  Equality Screening - Trust's Financial Plan 2015/16- overarching cumulative assessment  Equality Screenings conducted on each element of the Trust's Financial Plan 2015/16 including workforce contingency measures to ensure financial breakeven  Equality Screening and public consultation on the Proposal for Closure of the Minor Injury Unit, Armagh  EQIA condcuted on the Proposal for the Future of Statutory Residential Care for Older People in Southern Trust Area.

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The above examples of key service developments are illustrative and are not intended to be exhaustive. The Trust also fed into regional work streams, examples included the Regional EQIA on Self Directed Support led by the HSCB (NB: public consultation period ended May 2016); the proposal to move remaining HSC staff to a Single Pay Frequency in line with other HSC staff and the Regional Review of Ophthalmic Clinics led by the Belfast Trust. NB: The Single Pay Frequency was recently halted by the Minister for Health - see page 48 and 49 of this year’s report.

In view of the current economic climate the Equality Commission for NI has issued further advice to public authorities to stress the importance of adherence to S75 Equality Duties to ensure, at the planning stage, that policy formulation and decision making processes do not have a disproportionate and unintended impact on particular S75 equality categories i.e. people with different religious belief, political opinion, racial groups, different ages, different marital status, different sexual orientation, men and women, person with or without a disability and persons with or without dependants.

The cumulative assessment of the Trust’s Financial Plan 2015/16 was provided on request to the DHSSPS in response to ECNI correspondence – set out below for ease of reference:

Further: ECNI

Similarly at the time of completing this year’s S75 Annual Progress Report the

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Trust had carried out a high level ‘RAG’ rating assessment of its 2016/17 Financial Plan and had completed some preparatory work to ensure compliance with its S75 Equality Duties and Disability Duties.

 Ethnic Monitoring

Ethnic Monitoring of Service Users is in place on a number of key information systems – Child Health System, PAS, SOSCARE, SureStart and NIMATS. An audit of progress on implementation on each of these systems was carried out in July and August 2015. The ethnic monitoring leaflet for service users has been translated into the top five languages for use across all HSC Trusts. This has been circulated throughout the Trust. Information for staff in the form of ‘Key Tips for Staff’ has also been circulated and is available on the Trust’s intranet site. This information was also included in information packs for a Regional Midwifery Conference (23-1-15). Specific training has also been provided to other groups of staff e.g. through the Social Work Forum.

Of note the Regional Ethnic Monitoring Guidance was launched during the year under review. The Guide to Ethnic Monitoring of Services Users in HSC in NI along with supporting materials was issued by the Chief Executive of the HSCB to all HSC Organisations in March 2016 for implementation where ethnic monitoring data is currently being collected or planned to be introduced on information systems. The application of this new Guide is intended to help HSC commissioners/ providers to robustly capture critical patient/service user information on existing and emerging BME communities using HSC services. Most importantly, it is intended to help HSC organisations to identify any unmet need and to target their resources according in order to tackle health inequalities experienced by BME communities.

The Ethnic Monitoring Project in HSC has been positively referenced by the OFMDFM Race Equality Unit. The Trust has been represented on the regional working group by the Trust’s Head of Equality.

Ethnic monitoring of staff continues to be collated by the Trust and this has been enhanced by HRPTS self-service functions and used in the HSC Trusts recent recruitment campaign aimed at attracting overseas nurses. An informed induction programme is currently being developed to ensure the smooth integration of overseas recruits – this will include an element on cultural diversity.

 Legislative Developments

Extension of Age Discrimination Legislation into the Sphere of Goods Facilities and Services

A Commission lead event took place on 27th August 2015 which was organised and opened by the Chief Executive of the Equality Commission for NI entitled Strengthening Protection for all - Ages Proposals for Reform of Age Discrimination in the Provision of Goods, Facilities and Services (GFS).

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The Focus of the event was to examine the proposed Age GFS legislation and the implications this would present for service providers. The event was fully subscribed which reflected the level of interest.

The Trust’s Head of Equality provided a detailed response, on behalf of the Trust, to OFMDFM’s public consultation on the proposed Age Regulations – set in below for ease of reference.

Trust Response to Consultation on ‘Proposals to Extend Age Discrimination Legislation into the sphere of Goods, Facilities and Services’

The Southern Health and Social Care Trust welcomed the opportunity to respond to the OFMDFM’s current consultation on ‘Proposals to Extend Age Discrimination Legislation into the sphere of Goods, Facilities and Services’.

Whilst the Trust supports the proposed legislation, with its many positive features, it believes there is scope for more meaningful protection and seeks greater clarity in specific areas.

 The proposed extension of age GFS legislation addresses a significant legislative gap.  The proposed extension of age GFS legislation would therefore bring protection in line with other legislative provisions such as Section 75 of the NI Act 1998 and employment equality law and is therefore to be welcomed.  The Trust further welcomes the expansive way ‘age’ is defined in the proposal in that it could be a reference to a particular age - 65 year old, a range of ages or the way in which groups are described “pensioners”, “older people”, “the elderly”.  The proposed extension of the age GFS legislative is also timely in view of the ageing demographic with the proportion of the population aged 65 projected to increase by 63% to just under half a million people by 2032.  There are however significant weaknesses in the current proposal notably it excludes under 16s from the scope of the legislation and therefore fails to offer protection to children and young people. It therefore may be contrary to the United Nation’s Convention on the Rights of the Child and the European Convention on Human Rights and is not consistent with Section 75 of the Northern Ireland Act 1998 which places an obligation on public bodies to have due regard to the need to promote equality regardless of age.  The Trust further notes that whilst the equality assessment acknowledges that there is evidence that children and young people may experience discrimination on grounds of age and other ageist behaviours, there is no rationale in the consultation document as to why the proposed legislation would not extend to children and young people under 16.  Legislation which fails to provide protection to all age groups does not create equality.  The Trust notes that the proposal extends protection from age discrimination due to a person’s perceived or actual age – however confirmation is needed if age GFS legislation also covers discrimination due to association on grounds of age.  The Trust welcomes the proposed positive action exception and objective

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justification defence which will sanction any permissible forms of differential treatment on grounds of age, as there are indeed circumstances when age criteria may be used in a health and social care context for beneficial and justifiable reasons to help tailor an individual’s diagnosis and treatment plan.  The Trust however believes that the inclusion of broad or blanket exceptions may only serve to limit and weaken protection of age GFS legislation as such any exceptions must be narrowly construed and be justifiable.  The Trust notes the blanket exception within the proposed legislation in relation to care within the home. Clearly there are many private, family or home based activities which should not be regulated e.g. the care that a parent provides to their child. The Trust’s functions extend to the provision of services within the home e.g. fostering or healthcare services etc. which would fall within the current exception but which should be regulated. The Trust would therefore seek clarification on how this would be interpreted given that provision of care within the home is a core and important function of health and social care.

The Trust welcomed the opportunity to comment on these proposals and the opportunity it presents to work proactively with other HSC Trusts and HSC organisations in preparation for this forthcoming legislation. The Trust also welcomed any accompanying guidance which would assist service providers with the effective implementation and compliance with the new Regulations.

In addition the Trust’s Equality Manager wrote, on behalf of HSC Trust Equality Leads, to the Chair of the HSC Regional Equality and Human Rights Steering group to propose that preparatory work take the form of a collaborative approach as follows:

There are a number of reasons for suggesting a joined up approach namely:

(i) Preparedness – it was evident from the presentation by Dee Masters, Cloisters at the ‘Strengthening Protection for All Ages’ event (hosted by the ECNI, 27 August 2015) – that preparedness had stood the health sector in GB in good stead – there were few if any challenges under the new Regulations to date. (ii) Equality Leads would advocate a collective, top down, bottom up approach for reasons of thoroughness/robustness i.e. involving the whole sector – similar to the aforementioned GB approach - if only to rule out quickly where the new Regulations are unlikely to have an impact and to focus our collective efforts on areas of greatest risk/impact. (iii) Equality Leads are also in support of exploring the use of a single robust audit tool for reasons of consistency - to highlight where age or age criteria are in use within the sphere of GFS. (iv) Having identified where age or age related criteria remain in use this could be examined more closely to see if its continued use is capable of being objectively justified in all the circumstances and that it is in fact in the best interest of the patient/client etc. (v) Equality Leads would be happy to feed into this process and are keen to tap into any available tools together with the earlier experiences of our

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GB colleagues. (vi) Involvement of others* - advice could be sought from DLS re the robustness of any objective justification test necessary for the continued use of age or age related criteria – preferably in advance of the legislation being enacted. *There may also be merit in engaging/tapping into the expertise of the Age Sector given their extensive knowledge and expertise in this area and in order to anticipate possible areas of challenge and remedial action.

NB: The above serves by way of example just some of the key policy developments during the current reporting period.

Example of Key Service Delivery Improvements.

 NI – New Entrant Scheme (NINES) – A First Point of Contact The Trust working in collaboration with the Southern LCG, the PHA and the Health and Social Care Board is in the process of establishing an evidence based nurse- led service for new entrants into Northern Ireland who are resident in the Southern Trust. The NINE Service is being developed by the Trust’s Children and Young People’s Directorate and will be located at South Tyrone Hospital Dungannon.

NINES will provide health care advice and health assessments for adults and children who are new to Northern Ireland and who are not registered with a general practitioner.

NINES will offer a range of clinics across the Trust area including a weekly drop in clinic and monthly evening for new entrants. The Team will include a: Health Protection Nurse Specialist , Public Health Nurse for BME communities, a Bilingual health support worker and an Administrative Officer. The new service will provide initial health screening and will establish pathways, in collaboration with other key stakeholders, to ensure an equitable, evidence based approach to addressing the health and social wellbeing needs of disadvantaged and vulnerable new migrants.

Trends This service is necessary due to a high population of new immigrants coming to reside within the Trust area. The Trust has some of the largest proportion of migrants with clusters residing in Dungannon, Craigavon and Newry & Mourne. The highest proportion of those born outside the UK/ROI settled in the SHSCT (27.1%).

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Approximately 122,000 international migrants are estimated to have arrived in Northern Ireland between 2000 and 2010. Almost 10 per cent of babies born in Northern Ireland during 2010 had foreign-born mothers compared with 3 per cent in 2001. Similarly, the number of GP registrations by non-UK nationals rose from 7,200 in 2003 to 19,400 in 2007, before falling back to 11,900 in 2010. In relation to school enrolments, the 2010 School Census shows that just under 7,500 school children (primary and post-primary) have a language other than English as their first language, around 2.5 per cent of the total school population.

The Registrar General’s Annual Report (2014)1 indicated that the highest numbers of new migrants are coming from Poland and Lithuania, with a smaller but significant numbers of migrants coming from East Timor, Romania, Portugal, Spain, Slovakia, India and China. These trends are borne out in the statistics received on the uptake of interpreters, with the Southern Trust routinely drawing down close to 50% usage rate compared to other HSC Trusts. (See the most recent statistics – page 28 and 31 of this year’s report refers.)

The Public Health Agency (2014) report on diversity indicates that unlike other Local Commissioning Groups (LCGs) the 0-17 population is projected to increase in the Southern LCG and this growth reflects the increase in migrant population where in 2012, 16.8% of births were to non-NI born mothers. Demand for public services is therefore likely to increase as a result of current immigration trends.

There follows an insight to the range and type of services to be provided by NINES:

 A client held health assessment passport in a range of languages to enhance communication between primary and secondary care. Clients bring their health passport to subsequent health appointments with their GP/Hospital/NINES.  Facilitate registration with a local GP Practice. Clients can then receive a medical card to allow registration with dentists/opticians.  Provide general health screening through new client assessment including blood pressure, urinalysis, and blood glucose monitoring.  Provide brief intervention for lifestyle issues such as smoking and alcohol and signpost as appropriate to health improvement programmes.  Provide screening for communicable diseases including Tuberculosis, Hepatitis B/C and HIV.  Provide Mantoux screening and BCG vaccination in line with national guidance.  Fast track for chest X-rays allows early detection of Tuberculosis and onward referral to chest clinic for investigations and treatment if required.  Make appropriate referrals through agreed referral pathways to specialist services i.e. Respiratory TB Chest Physician, GUM clinic, Hepatology and the Rowan Centre.  Make direct referrals to the midwifery booking clinic in Craigavon Area Hospital/ Daisy Hill Hospital for women with a confirmed pregnancy that have not accessed maternity services.  Refer to key support agencies for new migrant entrants e.g. STEP, Sure Start Belfast Central Mission.

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 Develop effective partnership working with other BME organisations to enhance the health needs of this population.  Support clients by advocating on their behalf.  Provide confidential help and advice.

NINES was launched in the SHSCT on 1st June 2016 by the Chair of the Trust Mrs Roberta Brownlee. Prior to the official launch NINES had commenced part of the service in relation to Tuberculosis screening with clinics running on a weekly basis since the start of April, 2016. The clinics offer Tuberculosis screening to groups of nationals from high incidence countries of Tuberculosis. At all the clinics interpreting services is offered to those requiring language assistance, offering an equitable service to all service users.

These clinics are being accessed well to date with appointments being offered trust wide.

The progress of this new service will be highlighted in future S75 progress reports to the Equality Commission for NI and will feature in the Trust’s new Action Based Plan aimed at tackling health inequalities covering the Period May 2017 – April 2022.

 Hearty Lives Update Oct 2015

Hearty Lives is a three year project funded by the British Heart Foundation aimed at to improving the Heart Health of Irish Traveller and Black Minority Ethnic (BME) Communities in Craigavon Borough Council area. As illustrated above, the Southern Trust area has some of the largest population of BME residents in its geographical area. The benefits of the project included:

 increased GP registration  greater awareness of Primary Care, and  appropriate use of services  greater uptake of lifestyle programmes and  reduction in risk factors leading to cardiovascular disease.

See below progress made during the year under review aimed at tackling health inequalities in Traveller health:

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Irish Traveller women attended weekly groups over the summer of 2015 covering arts and crafts, healthy bingo and nutrition and promoting physical activity zumba with the women getting a health check before and after the sessions were completed. Some of the women also attended Fitzone circuit training weekly or twice weekly i.e. planning for walking and cycling programs and a modified Weigh to Health program. Cook It and Heartstart programmes were also delivered for Irish Travellers - youth groups.

Outcomes:  173 Travellers health screened  18 referred to GP  120 Irish Travellers have attended embedded lifestyle change activities with an additional 97 individuals benefitting

There was continued partnership working with the local Craigavon Intercultural Programme, Richmont Community Association, Splash Surestart, and Wah Hep – local Chinese Association. Events included Sportadown, Brownlow Festival and Southern Regional College Fresher’s Health Fair in the Lurgan and Portadown Campus and ongoing engagement with local employers.

Outcomes:  601 BME Health Screened  89 referred to GP, 21 BME assisted to register with GP  410 BME individuals have attended embedded lifestyle change activities.  124 Brief Interventions for smoking cessation and an additional 76 registered.  On the Elite Heartstart - 152 individuals have been registered 50 of them from the BME and Irish travelling communities with 7 individuals having been trained as Heartstart Facilitators as a direct result of Hearty Lives.  684 Non BME/Irish Traveller have been health screened as a result of the project.  RCN NI Awards 2016 - Jane Ferguson won the Public Health Award, sponsored by the Public Health Agency. Since May 2013 Jane has been Health Co-ordinator with the Hearty Lives Craigavon project which aims to improve the cardiac health of members of the Irish traveller and black and minority ethnic communities in the Craigavon area.

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 Trust Traveller Action Group – Tackling Health Inequalities

In December 2010, the Southern Health and Social Services Trust established a Trust Traveller Action Group to progress the recommendations emanating from the All Ireland Traveller Health Study report as they pertain to the Southern Trust.

The Traveller Action Group (TAG) continues to meet every 3 months to share information on support services available for Travellers; to ensure that these services are suitable in meeting the Travellers’ health needs; and to ensure that Travellers are aware how to access them.

The Traveller Action Group is chaired by the Assistant Director Promoting Wellbeing and there is representation from:

 Other departments within the Southern Health and Social Care Trust  Local Traveller Support Groups  Safe and Well  Early Years Toybox  Traveller Education Support Service  Housing Executive  Public Health Agency

Travellers did attend for a number of years when the group was established in 2010 however during 15/16 there has been no direct Traveller involvement. Traveller Support Group workers feedback to Travellers on the progress being made by the group and bring issues from the Travellers they work with to the meetings for discussion.

Progress during 2015/16 includes:  The appointment of new staff within the Trust provide additional services for Travellers including an Early Intervention Coordinator, a Public Health Nurse and a Health Training Coordinator.  Membership of the group extended beyond health and wellbeing.  Implementation of an action plan which covers 8 key areas including Housing and accommodation; early years support and educational attainment; employment and skills; reducing stigma; Traveller friendly HSC services; targeted health and wellbeing programmes; monitoring evaluation and research and collaboration and joint working  Transforming Learning Communities – delivery of 101 courses to 616 Travellers  Safe and Well Project– 181 Travellers benefitted from a range of programmes to improve health and wellbeing, safety in one’s own environment, knowledge of local community opportunities, citizenship and active learning  Hearty Lives Craigavon Project provided – 181 Traveller with Cardiovascular risk factor screening, 18 were referred to a GP and 120 attended lifestyle change programmes  17 Travellers completing Community Health Champion and Health Trainer programmes

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Mary Black Assistant Director of Public Health, Health and Social Well-being Improvement, Public Health Agency wrote to the Trust during the year under review, to thank the Trust for sending through the Trust’s Traveller Action Plan and Review Report. She acknowledged the fantastic range of work underway and how it is all building and commended the efforts of the Trust for working to integrate action to improve the health and wellbeing of Travellers into other Trust priorities. She ended by saying that it was warming to see the links with the new programmes that we have been investing in and making it real. The Trust responded adding that it was very much a team effort reflecting what can be achieved when all the sectors work well together to improve the health and wellbeing of Travellers. Further details can be found in the Traveller Action Group Progress Report 2015/16 – see appendix 1.

Regional Traveller Health and Wellbeing Forum  Traveller The Public Health Agency (PHA) and Health and Social Care Board (HSCB) convened a Travellers Health and Wellbeing Forum in October 2010. The Forum, representing the PHA, Health and Social Care Board, Health and Social Care Trusts, Education Authority, Traveller support and relevant voluntary sector organisations agreed to commit to undertake actions based on the findings and recommendations of the All Ireland Travellers Health Study, particularly those relating to health and wellbeing. The aim of the Travellers Health and Wellbeing Forum is to improve the health and wellbeing of Travellers through developing better coordination, sharing models of best practice and shaping future services. Notable progress during the year under review was as follows:

 Production of a Regional Traveller Health and Wellbeing Plan  Production of a Traveller Education Action Plan  Production of a regional Traveller newssheet. There have also been 3 newssheets produced to date by Southern area, Western and Belfast Trusts with an emphasis on local activity, projects and regional articles.  Completion of guidance by DHSSPS with input from HSC Trusts to be issued to all staff on how to capture ethnicity to inform and shape service provision.  Successful tender process in place for Mental Health and Emotional Wellbeing for Travellers to be rolled out to Travellers in Belfast, Western and Southern Trust area. h &  Belong Partnership

The BELONG partnership has completed its five year programme aimed at supporting children from minority ethnic backgrounds - increasing their resilience and capacity to negotiate the challenges they and their families face in school, in the community and in engaging with the statutory bodies providing education, health, social and wellbeing services.

With significant financial support from The Atlantic Philanthropies, the multi- sectoral partnership experimented, piloted, evaluated, persevered and progressed,

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learning and developing along with the communities in which pilots were based, and testing models with the support of experts in the theories of family and children, community development, education, exclusion & inclusion, ethnicity and implementation, scaling up and digging down. The end result is valuable learning with children & their families as the primary teachers. Experience from the project is being shared, mainstreamed, adapted and applied to inform and improve practice.

The BELONG Programme hosted a final showcase event to mark the closure of the project on Friday 9th of October in Malone House, Belfast to celebrate the success of the programme over the past number of years; to review its achievements and to share in the launch of the final learning product - a quality learning resource which will be made available to all working at the intersection of ethnicity, children’s rights and child centred learning and development.

 Tackling Health Inequalities – Men’s Health

The Southern Health and Social Care Trust is calling on men aged over 65 to attend for an important health check for swelling of the main artery known as Abdominal Aortic Aneurysm (AAA). Men are six times more likely to have an AAA than women. The Trust has teamed up with the Abdominal Aortic Aneurysm Screening Service (AAA) to launch a new clinic at the John Mitchel Place in Newry. Over 40 men booked an appointment in the clinic prior to the opening and many more are being urged to come along. The test which is a quick and simple ultrasound is delivered by the AAA screening team from Belfast Health and Social Care Trust and patients are given their results at the appointment. This is all part of the Northern Ireland Abdominal Aortic Aneurysm Screening Programme (NIAAASP), which was introduced by the Public Health Agency in 2012 to reduce mortality from ruptured aneurysms. Men aged 65 will automatically be invited to the NIAAASP.

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 Regional Interpreting Service – Providing Accessible Services

During the year under the following recommendations emanating from the regional review of the Interpreting service came to fruition: . The establishment of Regional Advisory Group to inform the strategic direction of this service . The Establishment of a Service User Panel . The ‘Go Live’ of an New IT Web Based Portal for the management of all future bookings of face to face interpreters via the NIHSCIS.

Regional Advisory Group In 2014 the HSCB Board approved the recommendations of the Review of Future Arrangements for Language Interpreting and Translation Services for Health and Social Care in Northern Ireland (the Review).

The Review’s recommendations included the establishment of a Regional Advisory Group, reporting to the HSCB to oversee the development and delivery of interpreting and translation services including governance and accountability issues. The Group is to include patient and client representation.

The Regional Advisory Group has now been established within the context that interpreting and written translation services will in future be delivered on the basis of a regional shared service, provided by the Business Services Organisation (BSO).

This transition has since taken place in that BSO is now responsible for managing the NI HSC Regional Interpreting Service – primarily as it was seen as better strategic fit to host this as common service for all HSC organisations to draw upon.

The Aim of the Regional Advisory Group is to oversee the delivery of language interpreting and translation services for health and social care in NI and take responsibility for the future development of the services to ensure quality and timeliness of service, accessibility, financial stability and compliance with the agreed governance arrangements.

Specifically, the Advisory Group will:  Monitor and influence performance in accordance with the Service Level Agreement between HSCB and BSO;  Identify, as necessary, specific areas for service improvement;  Ensure effective patient and client involvement.

The Advisory Group will be accountable to the Senior Management Team of the HSCB.

The Membership of the Advisory Group will include:  HSCB Commissioning (Chair)  HSCB Finance  HSCB Integrated Care  BSO Shared Service management lead

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 BSO Shared Service operational lead  Representative of Service User Panel  Independent contractors (GP, Dentist, Optometrist, Pharmacist)  Trusts It is proposed that the Advisory Group will meet on a twice yearly basis. Further meetings and smaller task groups may be convened. Lynda Gordon, Head of Equality, SHSCT and Orla Barron, Equality Manager, Belfast HSC Trust have been nominated to represent the interests of all HSC Trusts on this regional advisory group. NB: The reporting arrangements no doubt will be reviewed in light of the Minister’s announcement concerning the HSCB.

Service User Panel A service user panel (i.e. patients and clients and their representatives) will also be established to operate alongside the Regional Advisory Group. One member of the panel will be invited to attend the Advisory Group meetings. The Patient and Client Council will be represented. As previously reported 2 members from the Trust’s Race Equality Forum have also expressed an interest in participating in this user panel in view of the fact that the Trust is the biggest user of this service.

New IT Portal Goes Lives To ensure the smooth deployment of the new IT web based portal (for the booking of all future face to face interpreters) staff enhancement sessions were rolled out across the Southern Trust during the current reporting period. In total of 8 sessions were held throughout the Trust’s geographical area to maximise uptake as follows:

Session Location Session Date Session Time Classroom, Nurses Home 11th February 10.30am – Daisy Hill Hospital, Newry 2016 11.30am Classroom, Nurses Home 11th February 12.00noon – Daisy Hill Hospital, Newry 2016 13.00pm Boardroom, SHSCT HQ 19th February 14.00pm – 2016 15.00pm Boardroom, SHSCT HQ 19th February 15.15pm – 2016 16.15pm Parent Craft Room 26th February 10.30am – Maternity Unit, CAH 2016 11.30am Parent Craft Room 26th February 12.00noon – Maternity Unit, CAH 2016 13.00pm Lecture Theatre 8th March 2016 14.15pm – South Tyrone Hospital 15.15pm Lecture Theatre 8th March 2016 15.30pm – South Tyrone Hospital 16.30pm

In addition 3 engagement sessions were also held to raise awareness of the transition arrangements to the new web based portal.

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The new HSC IT Interpreting Service system is now up and running and will encourage appropriate service use between face to face and telephone interpreting, ensure accurate and efficient service delivery and allow more meaningful service monitoring. Implementation took place on a phased basis by Trust locality as follows:

Trust Locality Implementation Date South Eastern HSC Trust November 2015 Western HSC Trust December 2015 Northern HSC Trust January 2016 Belfast HSC Trust February 2016 Southern HSC Trust March 2016

Staff from the BSO Interpreting service worked closely with the Trust’s Equality Unit staff in the lead up to ‘go live’ to ensure service provision was maintained at the same high standard and to ensure a smooth transition through verification of all Trust staff who require access to the portal.

The transition went ahead smoothly with no interruption to front line services.

No of Interpreting Requests

The total number of interpreting requests by the Trust for face to face interpreting for the period for 1st April to 31st March 2016 was 46,476. The top main languages spoken in the SHSCT were as follows:

Top Main Languages - SHSCT

Polish Lithuanian Portuguese Tetum Bulgarian Romanian Russian Latvian Slovak Hungarian Chinese - Cantonese Chinese - Mandarin Czech Spanish

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Regional Top 20 Languages

Polish Lithuanian Portuguese Romanian Chinese Mandarin Tetum Slovak Hungarian Arabic Chinese Cantonese Bulgarian Russian Latvian Somali Czech Chinese Hakka Spanish Farsi Bengali Urdu

Top 40 Southern Area Departmental/Practice Breakdown 1 April - 30 June 2016

Department Requests  Outpatient Departments 976  Health Visiting Departments 600  Physiotherapy Departments 573  Parkview Surgery 521  DJ Maguire and Associates 428

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 Acute - Integrated Maternity and  Womens Health 424  Family Intervention Team 398  Riverside Practice 354  X-Ray Departments 330  Maternity Department (Daisy Hill) 226  Speech and Language Therapy 217  McCarters Dental Practice 216  Children & Young People 213  The Northland Surgery 209  Mental Health Services 194  Bluestone Unit 170  Newtownhamilton GP Practice 164  Bannview Medical Practice 161  Meadows Family Practice 159  Gateway 149  Acute Services 140  Dr Mulvaney and Flood Cornmarket  Surgery 133  Lakes Family Practice 133  Moy Health Centre 133  Radiology 131  Burnett, Winter, MacDonald 128  Wynne Hill Surgery 123  Clanrye Medical Practice 122  William Street Surgery 106  Community Midwifery 101  NINES B Floor STH 101  DR S F MacDonald 100  Community Addiction Service 92  The Archway Surgery 86  Dr O’Connor and Morgan 82  Looked After Children 82  Community Dental Service 79  Orthopaedic ICATS 78  Orchard Family Practice 76  Yew Tree Dental Practice 73

 How to Access health and Social Care in your Local Area – Promoting Access to Services

A review of this information booklet was undertaken during the previous reporting period 2014/15 and aims to help those:

 unfamiliar with the NIHSC system  with way finding and  appropriate use of HSC services.

This newly revised booklet was launched in Autumn 2015. The launch was timely given the arrival of incoming asylum seekers to NI.

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This information leaflet has been translated into 10 minority ethnic languages to reflect the diversity of languages spoken across NI. Copies have been uploaded to the Trust’s website under ‘Policies and Procedures’ Equality Section and are being used by service managers.

 Challenges facing Minority Ethnic Communities in Rural Northern Ireland

A seminar took place on Thursday 8th October 2015, Armagh City Hotel – hosted by the Stronger Together Network in partnership with the ABC Interagency BME Network the focus of which was “Challenges facing Minority Ethnic Communities in Rural Northern Ireland”. A warm welcome was extended by Eliza Hughes, Stronger Together, with Stephen Smith, Community Intercultural Programme, setting the scene. Brenda Toal, SHSCT, addressed health issues facing BME communities. This was followed by table discussions on employment issues facing rural BME communities led by Nigel Stockdale, Gangmasters Licencing Authority, and education/training issues facing BME communities led by Kellie O’Dowd, Trademark Belfast, and rural BME integration led by Richmond Rural Community Association. The programme ended with a focus on Funding Through Council with inputs from Patricia McElduff, Armagh City, Banbridge & Craigavon Borough Council.

The purpose of the seminar was for network members and other participants to work through the challenges faced by minority ethnic communities living in rural areas across the province. 53 participants attended the seminar from across 30 organisations.

The recommendations from the event are summarised below and will be taken into account in development the Trust’s new Equality Scheme Action Based Plan covering 2017-2022.

Health & Wellbeing  Enable BME families and individuals, living in isolated, rural locations to register with GPs and dentists and avail of health promotion services.  Health service staff become more culturally aware of BME needs and methods of engagement with BME communities in rural areas  Service provision benefiting BME communities in rural environments becomes more flexible and effective.  Empower indigenous groups to become more engaged in the integration of BME communities. Employment & Entitlement  Provide BME communities in rural areas with access to appropriate information and support mechanisms that empower them to identify and report breaches of worker’s rights, exploitation and receive any entitlements due to them.  Develop a joined-up, clear message approach with all appropriate agencies and statutory bodies in identifying exploitation, supporting exploited workers, enforcing regulations and highlighting good practice.  Develop inspection processes that protect worker’s rights in the food production and processing industry – from recruitment agencies, food producers & businesses by both enforcement agencies and supply chain

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stakeholders.  Employers provide all BME employees with adequate workplace health & safety and other appropriate training opportunities  Provide training, information and support to BME individuals and groups regarding self- employment status and development of businesses opportunities. Education & Training  Provide BME communities in rural areas with access to English language courses delivered with a more flexible approach that meets the needs of learners, e.g. location, timing, child care, accredited / non accredited and personal ambitions.  Provide BME communities with increased knowledge of educational transitions and understanding how attainment levels are recognized in NI.  Provide BME communities with an increased understanding and access to parenting and general training programmes.  Deliver training and information which challenges myths and perceptions regarding BME communities.

The above findings will be fed into the Trust’s ‘Themed Inequalities Audit’ which in turn is used to inform and prioritise actions measures in the Trust’s Equality Scheme Action Based Plan.

 Trust’s Race Equality Forum

More Health and Social Care foster carers are needed across Northern Ireland in each of the five HSC Trust areas to provide safe, stable and loving homes for vulnerable children and young people for as long as they need them.

Currently in Northern Ireland there are almost 2200 Looked After Children (LAC) living in foster care. In the Southern Trust area there are approximately 400 looked after children with on average 8 children coming into care every month. The Trust is currently seeking to recruit foster carers across the region who can commit to providing respite care as well as those interested in fostering a child on a short-term or long-term foster basis.

An invitation was extended to Sheila Smith, from the Trust’s Children and Young Peoples Directorate to attend the Trust’s Race Forum on 16th October 2015 to address the current lack of Foster Carers to provide for mainly the number, type and varied needs of children come into care. It was noted in particular the service is lacking in the number of Minority Ethnic Foster Carers to provide for the cultural and ethnical needs of BME young people.

It was acknowledged that the Southern Trust has some of the largest numbers of Minority Ethnic communities living in its catchment area. The Dungannon Team, for example, has 20-25% of families who are from Minority Ethnic communities. In all there are 9 family placement teams across the Trust’s geographical area – 3 in each

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locality – A/D, N/M and C/B. Of note the number of Ethnic Minorities in the N/M area within CYP, which the Trust is currently working with, is negligible.

In terms of the way forward the Trust is to embark on a targeted recruitment strategy and in doing so welcomed input from the Race Equality Forum i.e. ideas or suggestions that would aid the success of this initiative. For example, how best to access Minority Ethnic communities, how best to promote opportunities for Foster Care with Minority Ethnic communities and how best to disseminate materials for maximum effect. It was acknowledged that the Forum and its database of Minority Ethnic communities was also a good starting point.

It was agreed that an initial mapping exercise was necessary to establish where and by whom BME young people are currently being care for.

In summary the following suggestions were put forward by way of consideration and to inform next steps:

 An Initial mapping exercise to be undertaken;  To draw down on the learning from the successful befriending model as described by the Craigavon Intercultural Programme Rep – Stephen Smyth;  Bespoke training for Foster Carers to create greater understanding of the needs of Minority Ethnic communities. Training to feature equality and human rights elements and cultural diversity;  Simplification of the approval/assessment process – which in the past has deterred applicants from Minority Ethnic communities – currently it is too complex/difficult;  Facilitated outreach events targeting local Minority Ethnic communities with translated literature and use of interpreters;  Targeting child minders who may be interested in becoming Foster Carers due to impending changes in the Taxation system;  Foster Care contact details to be circulated with the Race Equality Forum minutes;  Foster Care Service to share copies of the Adoption and Foster Care literature – Could you Foster? Could you Adopt? - together with details of the STAY initiative - aimed at providing temporary accommodation for young people aged 16/17 who are homeless or young people who have been in or leaving care – with BME representatives.

The Trust’s Race Equality Forum is chaired by the Trust’s Non-Executive Director, Mr Edwin Graham and Paul Yam, Wah Hep Chinese Association.

 Southern Trust Launches Foster Care Fortnight

Foster Care Fortnight 2016, Northern Ireland’s largest celebration of fostering, was launched on May 13 at Armagh City Hotel in partnership with the by The Fostering Network in Northern Ireland and the Regional Adoption and Fostering Service.

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 Blind Cord Safety Workshop

The Trust ran a Blind Cord safety workshop on Tuesday 8th December 2015 at Craigavon Civic Building to heighten awareness of a recent incident involving local Portuguese Parents who lost their toddler in a blind cord accident in Portadown. The couple willingly cooperated with the Trust in the creation of a DVD which recounted their story and is being used as an educational tool. The short film was launched at the start of the workshop in Craigavon with a number of invited quests including the local Mayor.

A leaflet from the British Blind and Shutter Association (BBSA) explaining about the dangers, new legislation around manufacturing standards and solution to preventing blind cord strangulation accidents among babies and young children has been translated into a number of minority ethnic languages:

 Cantonese  Hungarian  Lithuanian  Mandarin

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 Polish  Portuguese  Romanian  Russian  Slovakian  Tetum

The leaflets can be downloaded for free from the accident prevention page maintained on the Southern Trust website: www.southerntrust.hscni.net/livewell/1537.htm

The Saba family inquest took place on 23rd May 2016 following the death of their son Bryan.

There was radio coverage to promote awareness of the dangers of blind cords as well as coverage in the Newsletter, Belfast Telegraph and Irish News. The Coroner in this case has placed a spot light on the issue and made some important statements which it is hoped will reduce accidents as a result of cord blinds. The coroner is also to write to the new Minister for Health Michelle O’Neill to prioritise this issue. Locally the Trust will continue to include this in its home accident prevention activity. See below link to the video.

The video ‘Blind Truth’ can be located at: https://www.youtube.com/watch?v=30ziiHQZR5s&feature=youtu.be

 Launch of Accessible Communication Guide

On Monday 27th June the Health and Social Care sector in Northern Ireland launched a new piece of Guidance for staff. Patrice Hardy, Equality Commission for NI attended the launch and provided a key note address.

One in 5 people will experience communication difficulties at some point in their lives. Inclusive communication reduces barriers which are often created through people simply not knowing how to communicate effectively.

The guide aims to give staff practical tips and advice that will establish good practice and mean improved health outcomes for people with communication support needs and the wider community. Producing the guide with the community and voluntary sector was essential as the partnership working meant that people with expert knowledge and first-hand experience could influence this good practice resource for staff.

The guide will assist staff to make sure that people using health services have access to the appropriate communication methods that they need. The guidance gives practical advice and support to staff by signposting for example how to access Sign Language interpreters. It assists staff to think about the many different ways to communicate effectively i.e. - speaking, writing, sign language, photographs, pictures, symbols, objects, electronic aids, as well as non-verbal communications such as facial expressions, body language, sounds and gestures.

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The guide supports the Regional Physical and Sensory Disability Strategy.

Making Communication Accessible for All; A Guide for Health & Social Care (HSC) Staff’ is available on the Trust’s intranet under ‘Policies and Procedures’

Pictured above Equality Leads from the 6 Health and Social Care Trusts, the DHSSPS along with Patrice Hardy – Equality Commission for NI

Other notable key service developments – during the current reporting period included:

 Top Hospital 5 Year Record

For the fifth year running, the Southern Trust’s acute hospital network – Craigavon Area and Daisy Hill – was officially named as one of the Top 40 performing hospitals in the UK. The CHKS Top Hospitals award is based on the evaluation of over 20 key performance indicators covering safety, clinical effectiveness, health outcomes, efficiency, patient experience and quality of care.

The Southern Trust was also one of the top five in the UK for Patient Safety at the CHKS Awards as well as being the first in Northern Ireland to receive the National Data Quality Award (for Northern Ireland, Scotland and Wales). The Data Quality Award recognises a commitment to driving improvement in clinical coding and data quality to the highest standard.

Francis Rice, Southern Health and Social Care Trust Chief Executive (Interim) said: “Good data quality is crucial in ensuring that front line staff have the right information to effectively treat patients and provide the best possible care. The data quality award recognises the importance of timely and accurate clinical coding and the essential roles this plays in ensuring that we have information available for analysis on patient outcomes, diagnosis and treatment, which in turn helps us learn and improve provision of care. A lot of rigorous work goes on behind the scenes by our

PART A staff to ensure we have the highest standards in clinical coding and we are delighted that they have been given this recognition for demonstrating such outstanding achievements in quality improvement.”

Congratulating staff on this year’s awards, Southern Health and Social Care Trust Chair, Roberta Brownlee, said: “Last year in our very busy hospitals, there were 392,790 outpatient appointments, 135,392 Emergency Department attendances, 57,883inpatient admissions and 5,976 births. While managing over half a million patient contacts each year, our staff are committed to delivering a very high standard of care every day, for every patient. We are committed to promoting a culture of excellence within the Southern Trust and this recognition once again reassures all of our patients, carers and staff that their hospitals are amongst the best in the UK. I would like to pay tribute to every member of staff working in our hospitals who has played an important role in achieving these awards and am delighted that their commitment and dedication has been rewarded in this way.”

 Newry Care and Treatment Centre

Plans for the new Community Treatment and Care Centre in Newry gathered momentum during the year under review. The new £40m health hub in Newry will be located on the site of the old Abbey football pitch with the creation of over 100 construction jobs. The Trust is now moving towards the next stage in the development of the centre. Patients, staff and the whole community in Newry will benefit from modern state-of- the-art facilities and accommodation to support primary and community care services. The new centre will complement the many excellent services that will continue to be provided at Daisy Hill Hospital.

Development of community services is a key priority for the Southern Trust. The Trust already have a very well established Health and Care Centre in Portadown and a new state-of-the-art Health and Care Centre that has just more recently opened in Banbridge – see below. This new centre will bring together a range of services in a more accessible ‘one-stop’ environment for the people of Newry.

The Trust is currently working in partnership with the Strategic Investment Board (SIB), Health and Social Care Board (HSCB), Central Procurement Directorate (CPD), General Practitioners (GPs) and the Developer to finalise the detailed design for the project which is anticipated to be completed by summer 2019.

A range of community-based services in the Newry region will relocate to the new centre and there will be ongoing engagement with staff and service users as the project develops.

Additional services in the new centre will include x-ray, rehabilitation services, café and a range of bookable conference, meeting, clinical and interview rooms available for utilisation by Trust staff, GPs, Consultants and the Community and Voluntary Sector.

In keeping with the commitments in the Trust’s Equality Scheme a detailed equality screening was conducted on this new service development. Further, and in keeping

PART A with the ECNI Guide to the S75 Equality Duties, the Trust gave a commitment (with projects of this nature i.e. that are detailed and are to be put in place through a series of stages) to consider screening at various stages during implementation. Equality and human rights considerations were also mainstreamed within the procurement process and reflected in the procurement documentation. Trade Unions and a wide range of key stakeholders have been involved as part of the ongoing engagement arrangements.

 £16 Million Banbridge Development

The new £16 million Health and Care Centre and Day Care facility in Banbridge opened for business on Monday 25th January 2016. Banbridge Health and Care Centre and the Linenbridge Day Centre replace three existing facilities - the Health Centre at Scarva Street, Banbridge Social Education Centre for adults with a learning disability and Copperfields which provides day care to adults with a physical disability.

Around 220 staff will be based at the new Health and Care Centre providing a range of community services including physiotherapy, occupational therapy and speech and language therapy, specialist nursing and a wide range of visiting services who will access bookable clinical, interview and meeting room accommodation. A rehabilitation suite and two dental surgeries will also be amongst the services available. Alongside the Centre, the Day Care facility ‘The Linenbridge Centre’ has two wings for 46 learning disability places and 20 physical disability places.

Paula Clarke, Southern Trust Chief Executive (Interim) said: “Development of community services is key priority for the Southern Trust. As well as complementing existing services already provided on the

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Banbridge Health Village development, this new centre will bring together a range of services in a more accessible ‘one-stop’ environment supporting us to continue to transform care.”

Banbridge Health and Care Centre is on the Old Hospital Road, whilst the Linenbridge Centre can be accessed via Meeting House Road.

Roger Wilson, Chief Executive of Armagh Banbridge Craigavon Council said: “This new Banbridge Health and Care & Day Care Centre represents a significant investment in improving health care provision for people living in the wider Banbridge area. I am delighted to see this project come to fruition and delivered to a very high standard. The new centre will facilitate the concentration of health and social care services in high quality facilities that are attractive, comfortable and accessible to patients, visitor and staff. It will provide the environment necessary to improve multidisciplinary and multi-agency working on the one site. We are committed to working closely with the Trust to deliver a range of initiatives aimed at reducing health inequalities and encouraging healthier lifestyle choices in all parts of the borough.”

Paula Clarke, Southern Trust Chief Executive (Interim) who showed him around said: “We work closely with colleagues in the Armagh City, Banbridge and Craigavon Borough Council to improve local services and the health and well-being of the people of Banbridge. We welcome this visit by the Council Chief Executive and thank him for his continued interest in the new Banbridge Heath & Care Centre and his support for our staff who are working very hard to provide many excellent health and social care services to local people.”

To date the centre has received a number of prestigious industry accolades:  The Royal Society of Ulster Architecture Award 2016 - Best Public Building over £3m  The Royal British Institute of Architecture (RIBA) Ni Regional Award 2016  RIBA National Award 2016  RIAI (Royal Institute of the Architects of Ireland) Irish Architecture Awards - Health Winner ‘16  European Healthcare Design Awards 2016 – Highly Commended

 Completion of £15.5 Million Theatre Redevelopment The final phase of a major £15.5 million redevelopment of the main theatres at Craigavon Area Hospital has now been completed. Work began on the ambitious projects in May 2011 and completion of this final phase now means that the hospital’s main theatre department meets the highest modern quality standards. Two new theatres were constructed as part of the scheme which also included the refurbishment of existing theatres. The hospital’s main operating department now has; eight operating theatres including two for trauma and orthopedic surgery along with an orthopedic ward and associated support accommodation; a 22-bed recovery ward

PART A comprising of three segregation rooms, one fitted with a bariatric hoist, space for ‘twin-cots’ and a four bed multi-purpose bay. The development also includes a new waiting area for day-case patients; a seminar room for staff training; new staff rest room and changing facilities; and dedicated storage accommodation. The number of surgical procedures undertaken in SHSCT hospitals has been significantly increasing each year. Last year 16,587 surgical procedures took place at Craigavon Area Hospital alone, so this new development has been a very welcome and indeed, much needed boost. The environment for patients and staff is a key part of being able to deliver the highest quality care and the Trust is delighted its dedicated team of surgical experts from across the Southern Trust now have state of the art facilities to help them achieve this.

 New Paediatric Centre Work to make way for new paediatric centres at both Craigavon Area and Daisy Hill hospital got under way during the year under review. The building of the new paediatric centre is part of the overall plans to modernise hospital services for children and young people across the Southern Trust. The first phase of the development began on Craigavon Area Hospital site on Monday 29th February. The Trust’s Director of Children and Young People’s Service Mr Paul Morgan said: “We are delighted to start working on these plans which we have been developing since our public consultation ‘Changing for Children’ in 2010. We have a very dedicated paediatric workforce and look forward to having the highest standards of facilities to offer acute paediatric care across both We are continually developing our services to meet the changing needs of our population and improving standards of care. We are delighted to have completed the first stage of our enabling works to begin the building of our new centre”. All planned paediatric surgery for the Southern area will be centralised in a new purpose designed centre on the sixth floor at Daisy Hill Hospital in Newry. The first phase of work to make way for the new paediatric centre at Daisy Hill Hospital began on site on Monday 7th March. This first stage of works will make way for the new custom designed paediatric centre on the sixth floor of the hospital which will involve extensive movement of staff and services to other floors and buildings.

 Transforming your Care (TYC)

Transforming your care is the name given to the programme of work aimed at changing NI Health and Social Care System so that it meets the needs of individuals now and well into the future.

Transforming Your Care is focused on improving the care provided for individuals and families across NI. This means more care at home and less care in hospitals. It means supporting people to live as independently and healthily as possible, for as long as possible.

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The Trust has now started to see real, meaningful and positive change through the implementation of the reform plans – some specific outcomes are detailed below:

Day Opportunities

People with learning disabilities and their families want a menu of opportunities that they can choose from to ensure their days are busy, enjoyable and productive. Rather than going to a traditional “day centre” some people with learning disabilities want access to a range of activities which can include education, training, volunteering or paid work in and with their local communities.

The Health and Social Care Board ran a public consultation on the range of day opportunities available throughout Northern Ireland. The overwhelming view expressed was that all individuals should be offered the choice and opportunity to be involved within their local community and to improve the level of interaction and development of relationships with those outside of day centres. In May 2014, the Health and Social Care Board approved a Regional Model for Day Opportunities for Adults with a Learning Disability which is essential to ensure a modern, sustainable and quality service for all adults with a learning disability on a consistent basis across Northern Ireland.

In keeping with the commitments in its Equality Scheme the Trust has applied its S75 equality and PPI obligations in the local implementation of the review of day time opportunities in its geographical area.

Self- Directed Support

‘Self Directed Support’ relates to the way that individuals and families can have an informed choice about the way in which care is provided. It allows for greater control and more flexibility by individuals and families over a personal budget. This means that once a Trust agrees that an individual needs social care support they can work together with their key worker to agree how care is provided, that best meets their assessed needs.

The aim of Self Directed Support is to promote independence by offering more flexibility on how services are provided to people who are assessed as being eligible for social care support and it enables people to take more control over decisions which affect their lives.

The Health and Social Care consulted on Self Directed Support and accompanying Equality Impact Assessment over a 12 week period which ended on Friday 8th May 2015. HSC Trusts fed into and supported this process. Following analysis of feedback and comments, it is envisaged that Self Directed Support will be available across all Health and Social Care Trusts soon.

At Home with Reablement

The Reablement Service is now operating across all five Health and Social Care Trusts in Northern Ireland supporting people to live independently in their own home.

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Northern Ireland has one of the fastest growing populations within the UK. There are currently around 286,000 aged over 65 years which is set to increase by 45% by 2027.

The Reablement Service for Northern Ireland is a focussed, short term assessment and support service, usually lasting six weeks or less which will help you to do things for yourself rather than having to rely on others.

The service in each Trust is made up of a Team including Reablement Occupational Therapists and Reablement Support Workers. It is provided to people over 65 who require a Domiciliary Care Package, or need an increase to an existing Domiciliary Care package and where they have experienced a crisis, such as an illness, or deterioration in health.

In the last nine months nearly 3800 people have received the Reablement Service across the region, of which almost half required no further on going care package.

The Reablement Service helps to reduce hospital attendances and readmissions and to facilitate quicker discharge. It also reduces the number of people who require a service by simply enabling them to lead independent lives by improving their ability to do daily living activities at home through re-learning skills over a short period of time.

Daily skills such as washing and showering, getting dressed and in and out bed or meal preparation can be lost following onset of poor health or infirmity and sometimes also through gradual social isolation or the loss of a carer. Reablement helps individuals whose independence is at risk, to rebuild their confidence and to develop these daily living skills.

Teams across all 5 HSC Trusts are making a tremendous effort in offering a better quality of life for many individuals in order to support them retain their independence and enabling them to remain at home.

Trust Acute Care at Home

The Trust’s Acute Care at Home service is now offering hospital care to older people within their own house or nursing/residential home and has been getting well deserved national recognition for the service it provides. The First Consultant Geriatrician led Services of its kind in NI to date the team have prevented around 440 hospital admission and supported an earlier discharge for 100 people.

The Permanent Secretary to the Department of Health, Social Services and Public Safety, Mr Richard Pengelly paid a visit to the Southern Health and Social Care Trust during the current reporting period. Welcoming Mr Pengelly to the Southern Trust, Chief Executive (Interim) Paula Clarke said: “The Southern Trust is committed to continuously improving our

PART A services to ensure we deliver safe, high quality care in a caring and compassionate way”.

Amongst other key service developments Mr Pengelly also saw how the Trust is making Transforming Your Care a reality through for example, the new Acute Care at Home service which brings a wide range of traditional hospital treatments to patients in their own homes helping to prevent stressful and disruptive Emergency Admissions for many older people and also through the Trust’s Nurse-led Paediatric Decision Unit which provides a wide range of treatments for children and young people that avoids them having to stay overnight hospital where possible.

Mr Pengelly said: “I very much welcome the opportunity to visit the Southern Trust area to see at first hand and hear from the staff, the work being done across a number of development areas and specialities. The Acute Care at Home service and the Nurse led Paediatric Decision unit are excellent working examples of service transformation and represent the road map for the future provision of health care to people in their homes, helping to alleviate pressure in our emergency departments”.

Homecarers Care

The Southern Health and Social Care Trust has launched a new campaign to increase the number of domiciliary care workers helping clients live in the comfort of their own homes.

Angela McVeigh, Director of Older People and Primary Care launching the latest recruitment drive, said: “In the Southern Trust we are committed to promoting a better quality of life for every patient and client. In the Trust’s area, thankfully we have an increasing number of older patients living longer and some of these with more complex needs. We are recruiting Domiciliary Care Workers to help provide end of life care, support our older population and clients with learning disabilities and physical disabilities to live with dignity, for as long as possible in their own homes where they want to be”

Treatment at Home in Times of Mental health Crisis

A home treatment service in times of crisis is reducing the need for hospital admission for people with mental health conditions living across the Trust’s geographical area. Around one in four people in NI will experience a mental health problem at some point in their lives. The Trust’s Bluestone Unit offers short periods of inpatient care for people with Mental Health issues and Learning Disabilities and complements the wide range of community services available to ensure that clients can lead as normal lives as possible in their community

The above examples are not exhaustive and are intended to be illustrative.

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Please provide examples of outcomes and/or the impact of equality action plans/ measures in 2015-16 (or append the plan with progress/ examples identified).

A copy of the Trust’s S75 Action Based Plan can be seen at Appendix 1. The plan include notes of attainment and examples of progress for the period 1st April 2015 to 31st March 2016. The content of the Trust's Equality Action Based Plan has been informed by an ‘Audit of Inequalities’ which was undertaken in order to identify key inequalities for service users and those affected by Trust policies. As part of the Audit of Inequalities the Trust examined an extensive range of information sources, for example complaints received, customer surveys, monitoring information, research documents, annual reports, corporate plans, statistical information and health needs assessments etc. In addition, the Trust pre-consulted with a wide range of service users, service managers, voluntary groups and organisations, Trade Unions and Equality Commission for Northern Ireland amongst others in order to inform the development of this Plan. The Trust has given a commitment in its Action Based Plan to maintain a compendium of literature to ensure its log is relevant and up-to-date to inform ongoing and future plans – Action 15 refers.

The Trust’s S75 Action Based Plan includes a number of action measures which are short-term (1 year), mid-term (2-3 years) and long-term (3+ years), some of which may roll over into subsequent plans. These measures are aimed at reducing inequalities in health and social care - in furtherance of the Trust S75 equality duties, disability duties and human rights obligations. The Plan covers the period 2st May 2014 – 30th April 2017and includes measures which the Trust initiates, sponsors, participates in, encourages or facilitates.

It also includes regional and local measures which the Trust will work in partnership with other Health and Social Care organisations, voluntary and community sector, trade unions, etc. to achieve. The Trust has chosen measures and prioritised those that have the greatest impact on equality of opportunity and good relations.

Please note that this Plan is not the only means by which the Trust is actively seeking to address inequalities in health and social care and should be read in conjunction with other strategies and action plans e.g. Trust's Traveller Action Plan; Trust’s Race Equality in Health Action Plan; Trust's Carers Action Plans; Trust's Disability Action Plan; CAWT Initiatives aimed at tackling health inequalities; Thematic Regional Work streams e.g. Regional Ethnic Minority HSC Wellbeing Steering Group etc.

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3 Has the application of the Equality Scheme commitments resulted in any changes to policy, practice, procedures and/or service delivery areas during the 2015-16 reporting period? (tick one box only)

X Yes No (go to Q.4) Not applicable (go to Q.4)

Please provide any details and examples:

The application of the Trust’s Equality Scheme, equality screening, equality impact assessment and consultation have ensured that an equality lens has been brought to policy development, implementation and review processes as well as decision making processes across the Trust.

The application of the Equality Scheme commitments has resulted in changes to policy, practice and procedures and service delivery – see summary below. See also progress detailed against each action measure detailed in the Trust’s Equality Scheme Action Based Plan for the reporting period 2015/16 – Appendix 1 attached refers. There follow some examples by way of illustration:

 Trust’s 3 year Strategic Plan 2015-2018 – ‘Improving Through Change’

The Trust’s 3 year Strategy Plan ‘Improving Through Change’ 2015-2018 incorporates the Trust's commitment to the S75 equality duties. The Plan itself was equality screened and made available as part of a 15 week public consultation process which ended on Friday 11th September 2015. The Trust also give a further commitment in this strategy, in view of its strategic nature, to subject the proposals contained within its final plan to further robust equality screening and fuller Equality Impact Assessment and public consultation - where necessary and appropriate and as these proposals are further developed.

As part of the consultative process on its 3 year Strategic Plan the Trust was keen to ensure that as many local people as possible were able to share their views on this plan and in so doing promoted the opportunity for people to have their say via local press, via the Trust’s social media channels and also via written responses.

In addition, the Trust’s Chief Executive hosted a number of staff information sessions to inform staff of the Trust’s plans for the next 3 years and to welcome and encourage staff to express their views. Events took place as follows: Monday 24th Sept South Tyron Hospital, Tuesday 25th Sept CAH and Wednesday 26th Sept Daisy Hill Hospital.

NB: The Trust’s vision is to deliver high quality HSC respecting the dignity and individuality of all who use them.

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 Key Service Developments

Similarly the application of the Trust’s Equality Scheme has informed key services developments notable examples include:

The Future of Statutory Residential Care for Older People – initial equality screening which progressed to a full EQIA and public consultation.

The Future of Armagh Minor Injuries Unit – robust equality screening and public consultation.

During the year under review the Trust produced a Consultation Outcome Report showing how the views of people were taken into account in relation to the above consultations i.e. the Trust’s 3 year Strategic Plan and the 2 key service areas outlined above.

The Trust also updated the EQIA conducted on the Future of Statutory Residential Care for Older People to reflect the outcome of the public consultation and recommendations. This proposal was approved by Trust Board in October 2015, however, at the time of completing this year’s S75 annual progress report, the Trust was awaiting Ministerial approval to proceed in relation to the Future of Statutory Residential Care for Older People.

 Decision making Processes

The S75 equality duties have also informed the Trust’s Financial Plan. A S75 lens was applied to the plan itself in the form of a cumulative equality assessment as well as individual equality screenings on each of the proposals contained therein. Included amongst these was the continuation of workforce contingency measures to ensure financial break even at year end as well as proposed service changes.

 Other key functions of the Trust - Procurement

On Friday 14th August 2015 a regional procurement workshop took place. The workshop was hosted in fulfilment of one of the regional commitments in HSC Trusts’ Equality Scheme Action Based Plans i.e. action measure no 20 refers. The focus of the workshop was ‘HSC Procurement Commissioning and Planning – Human Rights and Equality Implications – Good Practice in Procurement and Contracts Management’.

June Turkington, Assistant Chief Legal Advisor, Business Services Organisation (BSO) provided a legal input on the legal duties as they related to S75 Equality Duties, the Disability Duties as well as Human Rights considerations. Procurement is an integral element of the commissioning cycle with stages 2 and 3 of this cycle i.e. ‘assessing the needs of the population’ and ‘making plans i.e. choosing priorities, specifying the service and quality standards need. The key stage in the commissioning cycle offer up a real opportunity to mainstream the S75 Equality Duties, Disability Duties and fulfil Human Rights obligations.

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Orla Donaghy, Head of Social Care Procurement, BSO provided an overview of the legal context governing public procurement in NI whilst drawing out good practice elements of a procurement process.

Examples where cited of innovative approaches to procurement and specification design.

An example of good practice, in the sphere of procurement, was the arrangements made by the Trust to procure a new Carers Contract – which provided for meaningful engagement and involved input from carers (service users) from the outset i.e. at the early design and development stage. S75 Equality Duties, the Disability Duties and Human Rights obligations were considered throughout the development of the contract specification before progressing to public procurement - in line with procurement law.

 Policy Development

The S75 Equality Duties apply to external as well as internal policies. The Trust continues to apply the tools of equality screening and EQIA where necessary and appropriate to internal policy development. There follows some notable policy examples during the year under review:

Move to Single Pay Frequency – The Trust fed into a regional equality screening in preparation for the proposal to move remaining HSC staff to a single pay frequency i.e. a monthly pay cycle in order to align all HSC on a single pay frequency with limited exceptions. For those staff directly affected the following mitigating measures were considered as part of the equality screening process.

The Trust also undertook a local equality screening to assess the full impact on local staff and to reflect the extent of its own local engagement arrangements and range of mitigating measures to support staff through the proposed transitional arrangements. At the time of completing this year’s report a robust and timely communication strategy was being rolled out by the Trust to alert staff and to inform them of the proposed change to their pay cycle and to enable them to make any necessary adjustments in good time. The Trust’s screening template was kept under review to reflect any further mitigation to support staff through the transition period.

In response to a referral to the Equality Commission for NI HSC Trusts were approached by the Commission seeking confirmation that equality screenings had been completed on this policy proposal. At the time of finalising this year’s report the Minister for Health Michelle O’Neill made the decision to retain weekly and fortnightly pay cycles- following an engagement hosted by West Belfast MP Paul Maskey with frontline healthcare workers and unions.

Michelle O’Neill said: “I have listened to the issues raised by those staff who would have been affected by the change in frequency of pay and decided to retain the current arrangements for weekly and fortnightly paid employees.

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“The change in pay frequency would have impacted upon some 12,000 staff particularly women on lower pay scales. I want to reassure those people that I appreciate their financial concerns and I do not want to add to their pressures.”

The Minister added: “The implementation of a single pay frequency is a complex task affecting staff across the health and social care sector. Engaging with staff and taking into account a range of factors, I hope those employees who would have been affected will welcome this decision.”

Smoke Free Policy – A robust equality screening was conducted on this importance public health initiative to discern the impact on S75 equality groups. Particular regard was paid to patients in areas such as mental health, learning disability, palliative care, and post-traumatic events. The Trust has given a commitment to work in partnership with Management, Staff, Trade Unions and Professional organisations to provide any additional support(s) in seeking to achieve the overarching aims of this Policy.

In order to promote equality of opportunity and to tackle health inequalities the Trust will target resources to achieve equality of outcomes for all S75 equality groups. Evidence based research has shown that smoking prevalence is considered to be higher amongst BME communities - according to Millwall and Karlson (2011) tobacco use among ethnic minority communities remains one of the biggest causes of health inequalities for ethnic minorities. In addition, the All Ireland Traveller Health Study highlighted that the Traveller community has a higher incidence of CVD, stroke, cancer and respiratory conditions than the general population resulting in marked lower life expectancy - https://www.ucd.ie/t4cms/AITHS_SUMMARY.pdf. People with mental ill health and chronic disease have a much greater burden of disease / Disability Adjusted Life Year (DALYS) in comparison to other diseases such as renal. There is also a higher prevalence of smoking associated with mental health disorders – up to 70% in comparison to 25% of general population (GHS, 2012). Smoking is a risk factor for all of these conditions.

As the implementation of the policy progresses and particularly in the aforementioned areas such as mental health, learning disability, palliative care, post-traumatic events, the Trust has given a commitment to closely monitor the impact of the policy. Where, as a result of monitoring, opportunities arise which would allow for greater equality of opportunity to be promoted, the Trust will ensure that measures are taken to achieve better outcomes for the relevant equality groups. The Trust will review its equality screening template accordingly.

Voluntary Exit Scheme – an equality screening was also undertaken on the Voluntary Exit Scheme. Further the Trust gave a commitment to monitor the practical out workings of this scheme i.e. to monitor the uptake by S75 categories.

Please refer to the Trust’s Screening Outcome Reports for details of policies screened during the current reporting period and for details of those that

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progressed to full Equality Impact Assessments – these can be found on the Trust’s website under Publications.

Has the application of the Equality Scheme commitments resulted in any changes to policy, practice, procedures and/or service delivery areas during the 2015-16 reporting period?

Of note Chapter 1 - of the Trust’s approved Equality Scheme sets how we as a Trust propose to fulfil the S75 duties in relation to the relevant functions of the Trust together with the Trust’s accountability structure.

Chapter 2 - of the Trust’s approved Equality Scheme sets out our arrangements for assessing our compliance with the S75 Equality Duties i.e. responsibilities and reporting, action plan and action measures. Appendix 4 - of the Trust’s approved Equality Scheme sets out the ‘Timetable for Measures Proposed’ to give effect to the commitments in the Trust’s Equality Scheme.

See table below for progress update:

Equality Scheme Difference made for Action Commitment individuals

Arrangements for assessing our compliance with S75 duties

Have in place The Trust has effective Decision makers are appropriate internal arrangements in aware of S75 Equality structures and place for ensuring effective Duties and the reporting compliance with the Section requirement to take into mechanisms 75 statutory duties and for account the needs of S75 monitoring and reviewing individuals in making any progress – the final decisions via equality accountability structure is screening, equality impact described in Chapter 1 of assessment processes, the Trust’s Equality engagement and Scheme. consultation - PPI. Trust Chair and Chief Evidence of progress is Executive are fully monitored via S75 annual committed to effectively progress report to the fulfilling the Section 75 Equality Commission for statutory duties across all NI. our functions (including service provision, employment and procurement) through the effective implementation of our Equality Scheme and have pledged this commitment in the Trust’s Equality Scheme.

Training and presentations provided to Trust Board and Senior Management Team evidencing progress.

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Ensure S75 duties are S75 Guidelines have been Trust Board, Senior mainstreamed within produced for Trust Board to Management Team, the Trust ensure effective Policy authors, Trust mainstreaming of the S75 senior managers are duties. aware of the S75 Equality Duties and commitments Quarterly Equality in the Trust’s Equality Screening Outcome Scheme. Training - Reports – published in the provided for Trust Board interest of openness and and SMT. transparency – available on the Trust’s website – Trust staff aware of evidence of screening Equality Duties – ‘S75 policies and service Equality Duties – What it developments. means to Me’.

EQIAs are signed off by the Effective and tangible Trust Board and SMT evidence of before and after public mainstreaming of the S75 consultation. Equality Duties with the Consultation Outcome production of Equality Reports are produced Screenings and EQIAs. showing how the views of individuals have been taken Informed decision making. into account in making any final recommendations. Prepare Section 75 Trust’s Head of Equality More outcome focused Annual Progress engaged with Equality report available to public Report (APR) and Commission (ECNI) via and S75 groups. include section in focus and sectoral group Trust’s own Annual discussions on the Report. development of new S75 Annual Progress Report Template.

Trust’s Head of Equality User friendly also participated in guidance/advice to give Commission led research effect to S75 equality into the experiences of duties and further embed public authorities notably these duties. Equality Screening and Equality Impact Assessment processes. Completion of an on-line questionnaire also brought worked experience to bear on the outworking of the S75 duties.

Action Plan

Development of The implementation of the The content of the Action Action Based Plan to Trust’s Equality Scheme Based Plan has been include performance Action Based Plan and informed by an ‘Audit of indicators and identified outcomes for the Inequalities’, pre timescales. Aligned reporting period can be engagement and formal to corporate and seen in appendix 1. consultation with a wide business planning range of stakeholders. Its

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cycle implementation has had a positive impact on all S75 Groups.

See notes of attainment for 2015/16 – Appendix 1 refers.

Arrangements for consulting

Consultation list Consultations carried out Up-to-date consultation reviewed and updated throughout the reporting list with new consultees period provided the added to list for future opportunity to update the consultation. Trust’s consultation list e.g. Trust’s Strategic Plan, Pre engagement with Future Provision of consultees resulting in Statutory Residential Care, more robust engagement Armagh Minor Injury Unit. process. Review of HSC Consultation Scheme. Alignment of PPI and S75 duties in the revised HSC Head of Equality Assurance Consultation Scheme – Unit attended ECNI event complimenting and on proposals re revised enhancing user Timeframes for involvement. Consultation - arising from Clause 65 of the Fresh Start Agreement. An informed response was provided by the Trust to the Equality Commission for NI setting out Trust’s views on these proposals.

Training re. Trust Board and Executive Key decision makers Consultation Team informed of ECNI aware of ECNI guidance guidance on Section 75 of which the Northern Ireland Act stresses the importance of 1998 and additional advice adherence to S75 on setting budgets – see Equality Duties to ensure, this year’s annual progress at the planning stage, that report for evidence of policy formulation and compliance e.g. cumulative decision making assessment of Trust’s processes do not have a Financial Plan. disproportionate and unintended impact on particular s75 equality categories In making any During the current reporting Views of represented decision with respect period the Trust consulted groups and individuals to a policy adopted or on e.g. ‘The Trust’s considered during proposed to be Strategy Plan – Improving decision making process. adopted, take into Through Change, the account any Future Provision of assessment and Statutory Residential Care consultation carried for Older People and the out in relation to the proposal to permanently policy close the Minor Injury Unit

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in Armagh. Detailed consultation feedback reports were presented to Trust Board prior to any final decisions being made.

Ongoing engagement Increased participation of through Trust User Groups s75 individuals and makes sure representative groups in decision groups and individuals making and policy views are taken into development account in decision making.

E.G. Development on a Staff, service users, new Carer’s contract representative groups and individuals inform and shape these new arrangements.

Provide feedback Acknowledgement of those Representative groups report to consultees who provided feedback to and individuals informed in timely manner in the public consultations of how their feedback formats suited to carried out during the influenced the decision(s) consultees reporting period. made/alternative policy outcomes. Themed Consultation Outcome Report produced providing evidence of how feedback influenced the decision made.

Consultation feedback Open and transparent reports made available on decision making. the Trust website.

All Trust documents made Provision of accessible available in an alternative documentation to facilitate format on request. participation.

Screening

Revise screening Trust policy development Impact on and feedback template and process ensures all Trust from representative accompanying policies are screening. All groups is integral to guidance notes. policies approved during decision making process. the reporting period were subject to S75 screening Transparent decision and appropriate making process for consultation. Trust’s Policy consultees and effective Scrutiny processes make consultation. sure equality screenings accompany policies for approval.

During the reporting period Consultees can challenge the Trust screened 20 decisions where they have policies and proposals. It the evidence to do so. carried out and consulted on 1 EQIA and fed into 2

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regional EQIAs.

Publish reports All quarterly reports for the Screening outcomes quarterly and in reporting period were made available to the public for accessible formats on available on the Trust’s consideration. request. website Open and transparent processes.

Publishing of EQIA During the reporting period Representative groups are reports. the Trust consulted on its informed of how their EQIA re ‘The Future feedback has been part of Provision of Statutory the decision making Residential Care for Older process. People’. The Trust received detailed feedback and was commended on its documentation by the age sector. A Consultation Outcome Report showing how feedback had been considered by Trust Board before making any final recommendations/decisions was produced.

Monitoring

Review of monitoring The Trust continues to Increased understanding information monitor by Section 75 of the make-up of the categories for all HSC staff. workforce to ensure This has been further promotion of equality of enhanced by the Employee opportunity and better Self Service functionality on information to identify any HRPTS. During the potential impact. reporting period the Trust used this monitoring information to inform all S75 Equality Screenings and EQIAs‘.

During the current reporting The Ethnic Monitoring period Ethnic Monitoring Project in HSC has been Guidance was formally positively referenced by launched by the HSCB the OFMDFM Race under covering letter to CEs Equality Unit. Trust Head to ensure the extension of of Equality participated in ethnic monitoring on this regional working existing and new IT group. systems.

Ethnic monitoring is in place Ethnic monitoring has on a number of key been incorporated into information systems – Child Data Quality Training for Health System, PAS, HSC staff and system SOSCARE, SureStart and users – to increase NIMATS. awareness of the need to gather this information and

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how it is integral to decision making.

Staff Training

Draw up a detailed Discovering Diversity A further 1741 staff have training plan Training continues to be completed this training. rolled out in the Trust – see the training section 24 of According to HSC Staff this year’s annual progress Survey 2015 there was a report. notably increase in the uptake of Equality and Work on two new modules Diversity training i.e. a 7% commenced during the year increase on 2012 figures. under review for use across the HSC sector - one for staff and one for managers aimed at increasing staff and managerial awareness. Focused training During the reporting period Greater awareness of the Trust provided focused equality, disability, human training as follows: rights and S75 duties.  Traveller Awareness Training delivered by Traveller Community  Disability Equality and VAT training co- delivered by the disability sector.  ECNI Guidance re savings plans.  Head of Equality provided on-going advice and attendance at meetings on S75 equality duties, screening and EQIAs processes.  LGBT Training – Rainbow  Human Rights Training – Director of Legal Services etc.  Working Well with Interpreters – engagement sessions with HSC practitioners and sessions to facilitate the deployment on the new web-based IT portal for the on-line booking of face to face interpreters.  Learning Disability Awareness – staff training - GAIN Guidelines refers

NB: See section 24 of this

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annual progress report for further details.

Arrangements for ensuring and assessing public access to information and services we provide

Ensure information Completion of Northern Implementation of Review we disseminate and Ireland Health and Social recommendations will services we provide Care Interpreting Service make sure a cost effective are fully accessible to (NIHSCIS) Review. In and efficient service is all parts of the accordance with the review provided and service community in recommendations, the users can continue to Northern Ireland NIHSCIS duly transferred to avail of language BSO on 1 October 2014. assistance support when required. Deployment of a new IT web based Portal system to More effective and facilitate on-line booking of efficient use of interpreting face to face interpreters. provision. Provide information in Arrangements are in place Information provided in alternative formats on to provide for the provision alternative formats to request of information, on request, increase understanding in alternative formats. and ensure effective communication in line with Examples include – commitments in the translation of Smoke Free Trust’s Equality Scheme literature in a range of and Patient/Client minority languages in Experience. advance of Go Live 9th March 2016.

Blind Cord Incidents – safety in the home – translated into a range of minority languages for the workshop hosted by the Trust early 2016.

How to Access HSC – translated into 10 different language – also used to facilitate with the integration of Syrian families to NI.

An increasing range of easy read materials have been made available in the Trust’s hospitals in response to the GAIN Guidelines. Provide interpreters 46,476 interpreting requests Service users and staff and sign language were provided during the supported to ensure good interpreters reporting period i.e. 1st April governance in information 2015 – 31st March 2016. provision and Polish 13755, Lithuanian communication. 12083, Portuguese 6564, Tetum 4503, Bulgarian 1690, Romanian 1678,

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Russian 1384, Latvian 1347, Slovak 1209, Hungarian 593, Chinese – Cantonese456, Mandarin 438, Czech 158 and Spanish 120. Southern Trust remains the biggest user of this Service compared with other HSC Trusts. Assessing access to Information in accessible Information available in information and formats: assessable formats. services E.G Increased range and Improvements in patient availability of materials in experience easy read format in hospital settings – in response to GAIN guideline.

Training for HSC staff on Learning Disability Awareness.

Complaints Procedure

How complaints are The Trust received no N/A raised, timetable for complaints relating to the responding etc. implementation of its Equality Scheme.

Any other measures proposed in equality scheme

Work closely with During the reporting period Collaborative working other public the Trust participated in ensures more effective authorities to Regional Equality and use of resources and exchange learning Human Rights Steering consistent approach and best practice Group, Regional Equality across health and social Leads meeting, Regional care. Equality Employment Network and participated on regional thematic workstreams e.g. Traveller Thematic Group, Ethnic Monitoring Project etc. Liaise closely with the During reporting period Effective relationships ECNI to ensure that meetings held with ECNI to between the ECNI and the progress on the develop new Annual Trust in the discharge of implementation of our Progress Report template the S75 Equality and Equality Scheme is and new screening Disability Duties. maintained template and participated in Commission led research into the out workings of S75 processes and discussion on Clause 65 of the Fresh Start Agreement re revised Consultation Timeframes.

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NB: The above examples are intended to be illustrative and are by no means exhaustive.

3a With regard to the change(s) made to policies, practices or procedures and/or service delivery areas, what difference was made, or will be made, for individuals, i.e. the impact on those according to Section 75 category?

Please provide any details and examples:

Policy/Practice/Procedure Target S75 What Difference was and or Service Delivery Group(s): or will be made for Area individual (Impact on S75 category) Greater range of service Service Area Age, Disability and options for older people Gender EQIA – Proposal for the Future whose views have been of Statutory Residential Care for considered throughout the Older People process including the right to remain in their existing residential care home should they choose and for as long as it meets their needs. Trust was commended by the Age Sector on its documentation and its inclusive engagement/ involvement processes. All staff and Service Users Policy All S75 categories will benefit from a smoke Equality Screening – Smoke free environment. Free Policy Exemptions are to be provided where legislation permits e.g. Residential Care Settings and lived in accommodation. Consideration of the needs of specific service users e.g. mental health and learning disability, trauma, palliative care as well S75 categories e.g. Traveller Health and their predisposition to respiratory illnesses – All Ireland Traveller Health Study refers.. Effective mainstreaming of Practice All S75 categories S75 Equality Duties in the Procurement Regional Workshop Commissioning and Procurement Process Provision of Goods, Service Area - Delivery of Age Facilities and Services in Goods, Facilities and Services line with the legislative Consultation on Age Regulations provisions i.e. based on needs assessment - free

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- GFS from age bias and only where age can be objectively justified. Addresses a legislative gap. Promotes Best Practice in Policy Gender Employment Policy Across Transgender Policy the regional and beyond. Inclusive and supportive environment.

Service Area – Access to Race - BME Clearer guidance for HSC Services communities and in practitioners and services particular those new to users who are unfamiliar Accessing Health and Social NI. with HSC system in NI. Care Information Booklet

Updated Guidelines subjected to Equality Screening.

The project aims to raise Policy/Practice Age 50+ policymakers and employers Workage Project awareness by demonstrating that targeted workplace interventions to improve job design and work organisation will facilitate and enhanced engagement and retention of older workers Ability to map trends in the Procedural Guidelines Race uptake of services by BME Further roll out of Ethnic communities and more Monitoring Project and Launch of accurately target unmet Regional Ethnic monitoring need. Guidelines – March 2016 to facilitate ethnic monitoring on existing and new IT systems Provision of an inclusive Policy/Practice Sexual Orientation workplace where everyone Continued Support for LGB&T can work in harmony without fear of intimidation, harassment and discrimination. Involvement from carers in Procurement Persons with dependants shaping and informing new New Carers Contract carer’s contract – tailored to the needs of carers. More Effective use of Deployment on new Web Race interpreters and matching of Based IT Portal patients/clients needs across the HSC. Good Practice Checklist Physical and Sensory Disability developed to ensure the Disability Strategy needs of people with disabilities are considered in the design and develop of health promotion programmes/campaigns.

“My Journey My voice” a

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powerful interactive multimedia exhibition which highlights living with a communication disability from a service user’s perspective was launched on 2 November 2015. Production of Guidelines PPI – Establishment of new Dependants aimed at targeting hard to Carer’s contract reach groups. Review of HSC Consultation Scheme. Increased social integration Anti-stigma Training LGBT and advocacy for LGBT groups in service planning and deliver Improved career pathways Gender Equality Research Gender for men and women in securing senior management position within the public sector. NB: The breakdown of male to female senior managers in the SHSCT i.e. Band 8a above was 40% Male and 60% Female figures. (Figures as at 13 May 2016). The current Non- Executive ratio is 3 males to 5 females.

Please refer to Appendix 1 of this year’s annual progress report for further details of achievement with regard to the change(s) made to policies, practices or procedures and/or service delivery areas, what difference was made, or will be made, for individuals, i.e. the impact on those according to Section 75 category.

3b What aspect of the Equality Scheme prompted or led to the change(s)? (tick all that apply)

x As a result of the organisation’s screening of a policy (please give details): See examples provided above. See also the Trust’s Screening Outcome Reports for the year ending 31st March 2016 – available on the Trust’s website, Publications section.

x As a result of what was identified through the EQIA and consultation exercise (please give details):

The EQIA on the Future Provision of Statutory Residential Care for Older People has led to a set of recommendations which were approved by the Trust Board. The Trust also fed into other regional EQIAs e.g. Self- Directed Support and the Regional Review of Ophthalmic Clinics led by the Belfast Trust.

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x As a result of analysis from monitoring the impact (please give details):

Example – Trust’s Smoke Free Policy – this Trust has implemented the policy flexibly to take account of specific circumstances. The Trust has given a commitment in its equality screening as follows:

As the implementation of the policy progresses and particularly in areas such as mental health, learning disability, palliative care, post-traumatic events, the Trust will closely monitor the impact of the policy. Where, as a result of monitoring, opportunities arise which would allow for greater equality of opportunity to be promoted, the Trust will ensure that measures are taken to achieve better outcomes for the relevant equality groups. The Trust will review its equality screening template accordingly.

As a result of changes to access to information and services (please x specify and give details): The deployment of a new IT web based portal, during the current reporting period, for the booking of face to face interpreters had led to more effective use of interpreters and matching of patient’s/client’s needs across the HSC. The increased provision of easy read materials for patients with a learning disability in hospital settings has led to more effective communication – in line with Improving the Patient/Client Experiences 5 standards – notably ‘communication’ i.e. “All health and social care staff communicate in a way which is sensitive to the needs and preferences of patients and clients”.

x Other (please specify and give details):

Engagement and consultation is an effective element of the Trust’s Equality Scheme in informing and shaping policy, service delivery and decision making processes. Examples include: Focus groups discussion with the Trans sector in shaping a regional policy – currently at a draft stage and will be subject to further consultation. Involvement of carers in shaping a new carer’s contract that more appropriately meets their needs. EQIA on the Future of Statutory Residential Care for Older People. This proposal was approved by Trust Board in October 2015, however, at the time of completing this year’s S75 annual progress report, the Trust was awaiting Ministerial approval to proceed with implementing the recommendations. The Themed Inequalities Audit – which was refreshed during the current reporting period and which underpins the action measures contained in the Trust’s Equality Scheme Action Based Plan - has been key to identifying and framing both regional and local action

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measures contained in the Plan. This audit will also inform the Trust’s next Action Based Plan covering the period May 2017 – April 2022.

Section 2: Progress on Equality Scheme commitments and action plans/measures

Arrangements for assessing compliance (Model Equality Scheme Chapter 2) 4 Were the Section 75 statutory duties integrated within job descriptions during the 2015-16 reporting period? (tick one box only) X Yes, organisation wide

Yes, some departments/jobs

No, this is not an Equality Scheme commitment

No, this is scheduled for later in the Equality Scheme, or has already been done

Not applicable

Please provide any details and examples:

Compliance with the S75 Equality Duties are stated in job descriptions under ‘Staff and Managerial Responsibilities’. Compliance with the S75 Equality Duties are also included in specific guidelines for Trust Board members and the Trust’s Senior Management Team. Arrangements and Responsibility for ensuring the effective and timely discharge of the Trust’s S75 Equality Duties are set out in Chapter 1 of this Scheme - Chapter 1 sets out how we as a Trust propose to fulfil the S75 duties in relation to the relevant function of the Trust together with the Trust’s accountability structure Equality objectives are specifically included in the job Descriptions of the Trust’s Director of Human Resources and Organisation Development and the Trust’s Equality Managers. They are also included as part of KSF – staff appraisals.

5 Were the Section 75 statutory duties integrated within performance plans during the 2015-16 reporting period? (tick one box only) x Yes, organisation wide

Yes, some departments/jobs

No, this is not an Equality Scheme commitment

No, this is scheduled for later in the Equality Scheme, or has already been done

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Not applicable

Please provide any details and examples:

S75 Equality Duties are explicit in:  The national Knowledge and Skills Framework (KSF) is the process linked to annual development of reviews for Trust staff and informs personal development plans. Equality and Diversity is one of the 6 Core Dimensions and is reflected as a key element on all job descriptions.  Equality and Diversity is also a key element of revalidation – long life learning aimed at maintaining high quality, safe services.  Trust's 3 year Strategic Plan - a commitment was given to apply the tools of equality screening and where necessary and appropriate to conduct Equality Impact Assessments in relation to the Plan itself as well as individual workstreams that emanate from this 3 year plan. In keeping with the Equality Commission's Guidelines the Trust will continue to use the tool of equality screening at each key stage of implementation.  Similarly, the S75 equality duties where explicitly included in the Trust's Financial Plans for 2015/16 - a cumulative assessment was undertaken of the Financial Plan to assess the potential impact on the S75 equality categories and to identify any mitigating measures. Each individual workstream emanating from this Plan together with workforce contingency measues (to ensure financial break even year ending 31st March 2016) were likewise screened with some of these proposals progressing to full EQIAs e.g. The Future provision of Statutory Residential Care for Older People.  S75 Equality Duties are routinely included in the Trust's own Annual Report.  Progress in implementing the S75 duties is also reported in the Trust's S75 Annual Progress Report and regularly to the Trust Senior Management Team and Trust Board.  Equality Screenings and EQIAs for key service developments are discussed at the Senior Management Team and signed off at Trust Board. All equality screenings progress with policy documents to the Policy Scrutiny Committee in the interest of compliance.  The Trust's Head of Equality provides ongoing training, hosts workshops for policy leads/decision makers and provides ongoing advice and expertise in the area of S75, the Disability Duties and Human Rights obligations. The Equality Manager acts as a business partner - participating in discussions at an early stage of policy development and decision making processes. Please refer to the training section (24) of this report for further details  The Trust also participates in regular audits of compliance. Feedback is provided through an accountability review.

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6 In the 2015-16 reporting period were objectives/ targets/ performance measures relating to the Section 75 statutory duties integrated into corporate plans, strategic planning and/or operational business plans? (tick all that apply)

x Yes, through the work to prepare or develop the new corporate plan

x Yes, through organisation wide annual business planning

Yes, in some departments/jobs

No, these are already mainstreamed through the organisation’s ongoing corporate plan

No, the organisation’s planning cycle does not coincide with this 2013-14 report

Not applicable

Please provide any details and examples: NB: See response to question 5 above. Section 75 Equality Duties are incorporated and mainstreamed at a strategic level into the business of the Trust. The Head of the Equality Unit reports directly to the Director of Human Resources and Organisational Development (and Director designate for Equality) who in turn is a member of the Trust’s SMT and Trust Board.

Objectives/ targets/ performance measures relating to the S75 statutory duties were integrated into corporate plans, strategic planning and/or operational business plans as follows:  The Trust's 3 year Strategic/Corporate Plan  The Trust's Financial Plan 2015/16  The Trust's Delivery Plan  The Trust's own Annual Report etc.  The Trust's People Management Framework 2014-2017  The Trust's Management of Change Framework is embeded in the principles of fairness and equity  Trust's S75 Progress Report which is presented to the SMT and Trust Board  Equality Screenings and EQIAs on Key Service Developments are discussed and signed off at SMT and Trust Board ahead of public consultation  Equality Screenings go to the Policy Scrutiny Committee along with the Policy Document  Equality and Human Rights are a standard section for consideration for all reports progressing to SMT/Trust Board.

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Equality action plans/measures

7 Within the 2015-16 reporting period, please indicate the number of:

Actions Actions Actions to 40 6 completed: ongoing: commence:

Please provide any details and examples (in addition to question 2):

See notes of attainment attached - Appendix 1 refers.

8 Please give details of changes or amendments made to the equality action plan/measures during the 2015-16 reporting period (points not identified in an appended plan):

There were no changes or amendments made to the equality action plan/measures during 2015-16. Plans are reviewed and monitored quarterly. At the time of completing this year’s annual progress report preparations were underway to develop a new action based plan covering the period 2017-2022. The Plan is to be consulted upon in the autumn of 2016.

9 In reviewing progress on the equality action plan/action measures during the 2015-16 reporting period, the following have been identified: (tick all that apply)

x Continuing action(s), to progress to the next stage addressing the known inequality

Action(s) to address the known inequality in a different way

Action(s) to address newly identified inequalities/recently prioritised

inequalities

x Measures to address a prioritised inequality have been completed

NB: of the 46 action measures in the Trust’s Action Based Plan, 40 have been completed and it is proposed that 6 will be carried forward into the Trust’s new Action Based Plan covering the period 2017-2022.

10 Following the initial notification of consultations, a targeted approach was taken – and consultation with those for whom the issue was of particular relevance: (tick one box only)

x All the time Sometimes Never

11 Please provide any details and examples of good practice in consultation during the 2015-16 reporting period, on matters relevant (e.g. the development of a policy that has been screened in) to the need to promote equality of opportunity

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and/or the desirability of promoting good relations:

Examples of good practice in consultation during the 2015/16 reporting period included:

 Trust’s 3 year Strategic Plan 2015-2018 – ‘Improving Through Change’ The Trust’s strategic plan explains how the Trust’s services would look like three years from now. Health and social care is constantly changing. This is driven by the changing needs of local people, by new technologies and ways of delivering care and by the resources made available to the Trust by the local assembly. It is therefore important that the Trust anticipates and plans for these changes and that it openly engages with its local communities and staff on how its plan to develop and improve the services it will provide in the future. During the year under review the Trust consulted publicly on its 3 year Strategic Plan for 2015-2018. The Trust was keen to ensure that as many local people as possible were able to share their views on its 3 year plan and to inform its final strategy. In so doing the Trust promoted the opportunity for people to have their say via local press as well as its social media channels and also via written responses. In communicating its strategy the Trust engaged with a wider range of stakeholders including staff, users, carers, staff representatives, voluntary and private providers, and local communities the DHSSPS, Health and Social Care Board, Southern Local Commissioning Group, Integrated Care Partnership, GPs and primary care providers throughout the consultation process. To help communicate the Trust’s vision a presentation was developed which helped to summarise the key elements of the Trust’s strategy. This presentation was made available on the Trust’s website http://www.southerntrust.hscni.net/about/ImprovingThroughChange.htm In addition the Trust’s Chief Executive hosted a number of staff information sessions to inform staff of the Trust’s Plan for the next 3 years and to encourage staff to express their views. Events took place as follows: Monday 24th Sept South Tyron Hospital, Tuesday 25th Sept CAH and Wednesday 26th Sept Daisy Hill Hospital. The consultation ended on Friday 11th September 2015.

In order to effectively communicate the Trust’s Strategy the Trust also used the following methods of engagement:

 Senior Management Team and Trust Board Meetings  Team Meetings with Staff  ‘Southern-i’ Electronic Newsletter  Global emails to staff  Meetings with Commissioners  Service User Groups  Share links to documentation with local Councils AND Assembly members and meet to discuss

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 Trust Internet and Website  Social Media – Twitter and Facebook

The Trust continued its engagement on the strategic direction outlined within this document over a 15 week period from Friday 29th May 2015 to Friday 11th September 2015 with the launch of its final Strategic Plan in October 2015.

The Trust produced a Consultation Outcome Report setting how it took into account the views of consultees in finalising its Strategic Plan a copy of which was made available on the Trust’s website.

 Consultation on the Future Provision of Statutory Residential Care for Older People

The Trust’s consultation on proposals for the Future of Statutory Residential Care for Older People commenced on 11th June 2015 for a period of 14 weeks and ended on 18th September 2015.

In preparation for the consultation process, the Trust completed an Equality Screening process in line with the Equality Commission’s guidelines. Through the equality screening process the proposals on the Future of Statutory Residential Care for Older People were assessed to be of major impact and it was therefore deemed necessary to carry out a full equality impact assessment. The EQIA has since been revised and updated as a result of feedback received.

A pre-consultation engagement process had been ongoing since 2013 when the Health & Social Care Board were asked by the Minister for Health, Social Care and Public Safety to co-ordinate a regional approach to this work. During pre- consultation the Trust undertook to inform residents, families/carers, staff and interested individuals and groups of its intention to consult on the Proposals for the Future of Statutory Residential Care for Older People.

Following endorsement of the Trusts change proposals by the Health & Social Care Board the Trust Board approved a formal consultation process at the Trust Board on 11th June 2015. Following this meeting, a notice of formal consultation was issued. All consultation papers were placed on the Trust internet site and statements were issued to the press. A printed copy of the ‘Proposal for the Future of Statutory Residential Care for Older People’, and how the full documents could be accessed, was issued to a wide range of consultees.

The Equality Commission and the Trust’s Equality Scheme recommend a 12 week consultation period; however for this consultation process the Trust extended its consultation period to 14 weeks, recognizing the summer period, to enable effective engagement and consideration of the proposals by interested parties. The formal consultation period commenced on the 11th June 2015 for a period of 14 weeks to Friday 18th September 2015.

During the consultation period a wide range of engagement and communication was undertaken with current residents in the care homes, families/carers, staff

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and wider community stakeholders including elected representatives and local Councils. The Trust openly engaged with a wide range of key stakeholders. A summary of the Trust’s engagement plan is detailed below:

 An active communication process was embedded to ensure that all current residents and their families/carers were kept appraised of all issues, reassured re the commitment to remain in the home and supported to participate in the consultation process  Briefings issued by email to elected representatives  The Trust issued an invitation to all councils and elected representatives offering a meeting with the Interim Chief Executive to discuss any of the three consultations taking place over the summer period, following which a number of meetings took place with individual elected representatives and local Councils  A number of press releases were issued to specifically remind the public that the consultation was taking place  Staff update sessions were held across a number of venues and various dates to update staff on the consultation.

The Trust accepted 48 late responses up to 13th October 2015 so as not to exclude any comments or information that would be relevant to decision-making.

During the consultation period the Trust responded to a range of requests for additional information from individuals, interested groups, elected representatives and Assembly Questions. A range of meetings with MLAs, other elected representatives, local councils and interest groups and individuals were also held.

As responses were received, the Trust acknowledged receipt, explaining to all respondents that their comments would be considered within Trust’s consultation process and a feedback paper to be tabled at Trust Board meeting in due course. Each response has been carefully reviewed and the key themes identified and considered in developing the final proposals for Trust Board consideration.

A total of 2,563 responses were received in response to the consultation including 22 completed questionnaires and two petitions.

This consultation outcome report set out:

 Summaries of the formal responses received  The key themes emerging from those responses  Consideration of responses and issues raised  Draft recommendations for Trust Board consideration

As detailed above the Trust engaged with a wide range of stakeholders in the development of this proposal through open engagement both in the pre- consultation and formal consultation stages.

The Trust Board considered the outcome report at its public meeting on 22nd October 2015 and made a recommendation that was shared with the HSCB and DHSSPSNI, for approval.

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The ultimate decision on the future of Statutory Residential Care Homes will be made by the new Minister for Health, Social Services and Public Safety.

 The review and modernisation of bed based short break provision (Respite) for individuals with a learning disability and their carers.

The Trust established a Learning Disability Carers’ Forum in 2013 consisting of 20 carers of individuals who had various levels of learning disability. The purpose of the Forum was to inform members of any proposed service changes, developments in respect of respite, day opportunities, day care, supported living and transition.

One of the significant concerns for the Trust was the development of bed based short breaks to enable carers and service users to have access to equitable short break opportunities in the areas where they live. In order to engage with carers who benefited from a bed based short break the Trust set about arranging for a series of Information Sessions to be held with carers. Information sessions were held with carers to find out how they feel respite could be provided.

One of the fundamental principles adopted by the Trust in advance of the Information Sessions was to share all of its concerns, pressures in a slide format to carers on the Forum to let them know what would be discussed in advance of the Information Sessions taking place.

A further guiding principle was that following the presentation by the Head of Service to the carers members the LD Carers’ Forum agreed to facilitate round table discussions with their peers. Trust staff were only used to take notes at the sessions.

At the Information Sessions the Head of Service made it particularly clear that in as much as the Trust had many very experienced staff delivering a bed based service, the specialists in the provision of care to individuals with a learning disability were the carers in attendance at the sessions and it was their valuable experience which was going to be used to inform future service developments.

It was also evident that the inclusion of carers from the Carers Forum as round table facilitators proved instrumental in ensuring that the Trust were very clearly seeking the valued opinions and views of the carers who attended the sessions.

Five information sessions were held with a significant number of carers across the three localities. Following presentation by the Head of Service round table discussions led by carers were used to help inform future service development. The Trust during its presentation made it very clear that there had been significant difficulty in providing short breaks equitably across the region and posed these challenges to carers to seek ideas from them as to how a service might be developed to ensure it is inclusive and equitable.

Following the Information Sessions, the feedback was collated and sent out to all 348 carers to share the concerns raised along with the recommendations from carers as to how they felt the service could be improved.

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The Trust sought additional feedback from any carer who had not been at the Information Sessions so that they were given the opportunity to contribute to the future vision for short break services.

All of the information gleaned from carers was used to inform an options appraisal for the most effective form of bed based short break provision for service users and carers. The options appraisal took place with a number of Trust staff and importantly with input from carers from the LD Carers’ Forum. It was indeed very evident that their inclusion and experiences helped Trust staff to have a greater understanding of the type of service they require.

Following the options appraisal and the selection of the preferred model, other carers from the LD Carers’ Forum agreed to take part in the development of the preferred model for respite. This included several meetings to examine the physical environment of a new facility, arrangements for day care, transport and more importantly governance for that facility. Meetings have proven to be very informative from both Trust and carer perspectives maintaining the value of the partnership as the underpinning basis for all discussions.

The formation of the Carers’ Forum has been very effective in enabling the Trust to fully understand the feelings of carers who have been and who will be affected by any changes in services. Exchanges between Trust and carers have enabled both sides of the partnership to gain a deeper understanding of each other’s positions. The resultant outcome is an open and transparent partnership with carers who feel their opinions are valued and respected.

Feedback from the Information Sessions was very positive as carers felt that they were included in any proposed service changes.

Outcomes  Carers felt more respected and valued as part of the comprehensive engagement process.  The Trust plan on using this extensive engagement style more widely in the future to seek opinion and service users on its services.  The development of databases ensured that all carers were consulted on service developments and their opinions sought for proposed changes.  Options Appraisals and service specifications more realistically designed to reflect carer and service user experiences.  Carers as facilitators at workshops proved more beneficial as carers believed that facilitators were much more impartial.

 SHSCT Smoke Free – Survey Results

During year under review, the SHSCT undertook a survey to establish the views of staff, patients, service users and the public about the plan to introduce smoke free sites. This was in response to the target set by the Minster for Health that all HSC sites should be smoke free by 9th March 2016.

The survey results demonstrated wide support for this move with 65.5% of respondents in favour of the Trust becoming completely smoke free. Just under

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25% said that they would not support his measure.

A total of 3,416 individuals responded to the survey. 61% of respondents were Trust staff or volunteers. The remainder were as follows:

Patient or Service User 13.8% Carers 1.4% Visitor 7.5% Member of the public 16.3% This was the highest response when compared to other HSC Trusts.

The Trust extended representation to service users, staff and Trade Unions to express an interest in becoming members of the Trust’s smoke free group(s) to inform the role out of this important public health initiative.

In terms of challenges to introducing smoke free sites the following issues were raised:

Compliance – concerns about how the Trust will be able implement this policy. Equity – concern were raised whether banning people from smoking in open grounds is an infringement of their rights. Some respondents felt that a whole-site ban should not be extended to personal vehicles. Patient safety – concerns were expressed regarding the safety of patients who may seek to leave the ground if they are unable to smoke on site. Impact on staff – concerns were expressed that staff on the ground may bear the brunt of ill-feeling, aggression and abusive language or behaviour in relation to the impact of having smoke free sites. Support to quit – views were expressed that more needs to be done to support those who will want to quit as a result of the introduction of a smoke free sites policy.

Of note a site visitation was organised to the Western Health and Social Care, during the current reporting period, to draw upon on and learn from the experiences of Western Trust colleagues in preparation for smoke free status. This visit took place on 8th September 2015.

In keeping with its commitments in its Equality Scheme the Trust undertook a detailed equality screening of this new policy paying due regard to S75 equality duties, human rights and disability duties.

The Trust gave a commitment in its equality screening as follows:

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The development of a detailed communication strategy in advance of Go Live 9th March has been instrumental in the successful implementation of the Trust’s Smoke Free Policy to date.

 Self Directed Support Stakeholder Engagement Event

A Self Directed Support Stakeholder Engagement Event took place on Monday 29th June 2015 at Seagoe Parish Centre, Portadown. This was the final event of the Regional Stakeholder Engagement events hosted by the Health and Social Care Board (HSCB) and was facilitated by the Southern Health and Social Care Trust (SHSCT). The Event provided information about the development of Self Directed Support (SDS) in Northern Ireland and in the SHSCT in particular and encouraged the engagement of a range of stakeholders in the rollout of SDS across the Trust locality.

Invitations were sent to 150 individuals and organisations across a range of stakeholders including; SHSCT contracted providers, carers and people who use Social care Services, voluntary, community and independent organisations, trade unions and SHSCT staff. A total of 91confirmed their attendance with attendance on the day of the event finalised at 75, not including speakers, HSCB and SHSCT organisational staff or graphic facilitators.

Of those in attendance at the event there was a mixture of people who received a social care service in the Trust, carers, SHSCT providers, voluntary and community groups, trade union representatives, SHSCT staff and representatives from other Trusts and the HSCB.

This was a live Twitter event as well as the compilation of a report compiled analysing levels of activity; and the audience reached through the use of social media before, during and after the event.

The event was imaginatively captured by graphic facilitators who worked tirelessly to depict the issues and strengths of the reality of SDS in people’s lives. This work has created a resource that will continue to be used to enthuse people about SDS.

Following on from Phase 1 the SHSCT team wanted the Event to capture the experience of the changes SDS can bring to people’s lives and used “podcasts” and speakers, who use Trust services from a range of programmes of care, as well as young people and adults to tell their story. From the feedback received - this approach was successful. Provider Organisations explained how SDS methodologies worked in their agencies; this, alongside the vision of SDS as well as the “nuts and bolts” presentations from colleagues in the HSCB and Trusts provided a powerful and timely message about SDS to all Stakeholders.

The second part of the Event explored the issues arising from SDS from the perspective of different stakeholders and encourage ideas to address the challenges and roll out of SDS. The attendees were divided into 3 Breakaway Groups facilitated by Implementation Officers. The Breakaway discussions were structured with TIO facilitators and scribes guiding the participants to focus on the topic and respond to five key points. Feedback and outcomes were recorded and

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broad themes emerged.

Other examples include:

 Trust’s engagement and response to Mental Capacity Bill.

 Engagement and response to the Public Consultation on the Proposal to extend Age Regulations into the provision of goods, facilities and services.

 Engagement in ECNI Led Event 26th April 2016 Fresh Start Agreement – Clause 65 - The Trust’s Equality Manager participated in the Commission’s public engagement event held on 26th April 2016 and provided an informed response to the Commission’s proposed revised wording.

12 In the 2015-16 reporting period, given the consultation methods offered, which consultation methods were most frequently used by consultees: (tick all that apply)

x Face to face meetings

x Focus groups

x Written documents with the opportunity to comment in writing

x Questionnaires

x Information/notification by email with an opportunity to opt in/out of the consultation

Internet discussions

Telephone consultations

x Other (please specify):

Please provide any details or examples of the uptake of these methods of consultation in relation to the consultees’ membership of particular Section 75 categories:  Smoke Free Survey – Staff and Service User Questionnaire  HSC Staff Survey – on-line Questionnaire  Short Breaks – Information sessions and focus Group discussion led by Carers  Public Consultation on the Future Provision of Statutory Residential Care for Older People – Questionnaires, face to face engagement, written responses, petitions etc.  Trust’s Strategic Plan – presentation, staff information sessions, meeting with MLAs, public consultation – questionnaires etc.

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Advocacy support is provided for those who require support with consultation for example – the public consultation on the Future of Statutory Residential Care for Older People. The Trust also continues to consult with established user groups such as the Trust Race Equality Forum, Carer’s Forum, Children and Young Persons Forum, Cancer Service User Group, Maternity Services Liaison Group, Traveller Action Group etc.

13 Were any awareness-raising activities for consultees undertaken, on the commitments in the Equality Scheme, during the 2015-16 reporting period? (tick one box only)

x Yes No Not applicable

Please provide any details and examples:

 Ongoing – training and awareness of S75 and PPI obligation – Trust PPI Leads – please also see notes of attainment action measure 18 – Appendix 1 refers.

 Equality Scheme - What it Means to You - booklet available for all HSCT Staff and as Service Users - raising awareness of S75 equality duties.  Trust Board Guidance and Briefing/Regular updates to both Trust Board and SMT  Ongoing support for established forums which represent the voice of the user e.g. the Trust's Race Equality Forum, Carers Forum, Trust's Traveller Action Group, Children and Young Peoples Forum etc.  S75 equality duties are discussed at established Forums e.g. Southern Trust Traveller Action Group, Maternity Liaison Group, Southern Trust Race Equality Forum and training has been provided e.g. for members of the Race Equality Forum on S75 obligations  Publication of quarterly Screening Outcome Reports - showing the outcome of equality screenings. In the interest of openness and transparency these are posted on the Trust's website for members of the public to review/challenge.  Public consultation and focus group discussions on key service changes/developments - completion of Equality Screenings and EQIAs - publication of same along with Consultation Document setting out S75 obligations and how these duties have been taken into account along with the direction and rationale for change.  Use of standard screening clauses in policy and consultation documents as standard practice and public/outward facing documentation.  Ongoing advice to policy leads - on project boards which include service users.  Trust Board Report - incorporates an update on the implementation of the S75 equality dutise - the readership of the Board report includes both staff and members of the public.  S75 Annual Progress Report - is also ultilised to raise awareness of S75 equality obligations and progress regarding same - this is availabe to all

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staff via the Trust intranet and website. 14 Was the consultation list reviewed during the 2015-16 reporting period? (tick one box only)

x Yes No Not applicable – no commitment to review

Arrangements for assessing and consulting on the likely impact of policies (Model Equality Scheme Chapter 4) [See Trust Website – ‘About the Trust ‘ - Publications section – Equality Scheme S75 – for details of quarterly screening outcome reports.

15 Please provide the number of policies screened during the year (as recorded in screening reports):

16 Please provide the number of assessments that were consulted upon during 2015-16:

3 Policy consultations conducted with screening assessment presented.

Policy consultations conducted with an equality impact assessment 1 (EQIA) presented.

Consultations for an EQIA alone.

The Trust also inputted to a number of regional EQIAs e.g. SDS led by the HSCB and the Regional Review of Ophthalmic Clinics led by the Belfast Trust.

17 Please provide details of the main consultations conducted on an assessment (as described above) or other matters relevant to the Section 75 duties:

Public consultation conducted with an equality screening assessment presented on the proposal to permanently close the Armagh Minor Injuries Unit. Public consultation conducted with an equality screening assessment presented on the Trust’s 3 year Strategic Plan – “Improving Through Change” 2015-2018. Public consultation conducted with an EQIA on the Proposal for the Future of Statutory Residential Care for Older People.

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18 Were any screening decisions (or equivalent initial assessments of relevance) reviewed following concerns raised by consultees? (tick one box only)

Yes No concerns No Not were raised applicable

Please provide any details and examples: See note below:

The Trust considers all feedback received and shows how the view of consultees are taken into considering in making any final decisions.

Arrangements for publishing the results of assessments (Model Equality Scheme Chapter 4)

19 Following decisions on a policy, were the results of any EQIAs published during the 2015-16 reporting period? (tick one box only)

x Yes No Not applicable

Please provide any details and examples:

EQIA on the Proposal for the Future Provision of Residential Care for Older People SHSCT was published and is available on the Trust’s website. The EQIA has since been update based on the feedback from consultees and a Consultation Outcome Report has been completed showing how the views of consultees have been taken into account in making any final recommendations. At the time of completing this year’s annual progress report a Ministerial decision is awaited re the recommendations on the Future Provision of Residential Care for Older People – SHSCT. Final EQIA will be made available on the Trust’s website.

Arrangements for monitoring and publishing the results of monitoring (Model Equality Scheme Chapter 4)

20 From the Equality Scheme monitoring arrangements, was there an audit of existing information systems during the 2015-16 reporting period? (tick one box only)

x Yes No, already taken place

No, scheduled to take place at Not applicable a later date

Please provide any details:

An audit of the following systems was undertaken and ethnic monitoring has been extended to the following systems:

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 Child Health Information System - CHIS  SOSCARE - Social Care information system  SureStart  NIMATS  Patient Admin System (PAS) - Hospital Based  Ethnic monitoring is also included on the new HRPTS staff information system  The Themed Inequalities Audit has been updated during the current reporting period and will inform the Trust’s new Action Base Plan aimed at tackling inequalities in HSC.

In addition:

 PARIS - new electronic integrated system – includes ethnic monitoring  NINES – NI New Entrants Scheme will monitor the uptake of its service by ethnicity. This service will target new arrivals to NI not registered with a GP.

21 In analysing monitoring information gathered, was any action taken to change/review any policies? (tick one box only)

x Yes No Not applicable

 Traveller Action Group – monitoring information used to inform Traveller Action Plan 2015/16 – aimed at tackling health and social care inequalities. Regular reports are provided to the Trust Board and PHA.  Updated Themed Inequalities Audit – will be used to inform the action measures to be contained in the Trust’s new Equality Scheme Action Based Plan 2017-2022. Please provide any details and examples:

 As a result of monitoring there have been changes effected to the regional interpreting service - see earlier note - section 1 refers. The deployment of a new IT web based portal will ensure the most effective use and matching of interpreters for those in need of language assistance.  As a result of monitoring the uptake of services a specific action plan has been drawn up to address health inequalities for some of the most marginalised groups e.g. Traveller Action Group - see progress section 1 of this report refers.  NINES – monitoring will enable staff to target their resources effectively. The new service was formally launched on 1st June by the Chair of the Trust.

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22 Please provide any details or examples of where the monitoring of policies, during the 2015-16 reporting period, has shown changes to differential/adverse impacts previously assessed:

The HSCB Guide to the Ethnic Monitoring of Service Users in Health and Social Care in Northern Ireland was launched in March 2016 for implementation where ethnic monitoring data is currently being collected or planned to be introduced on information systems. The application of this new Guide is intended to help HSC commissioners/providers to robustly capture critical patient/service user information on existing and emerging BME communities using HSC services. Most importantly, it is intended to help HSC organisations to identify any unmet need and to target their resources according in order to thus tackle health inequalities experienced by BME communities. The lack of available data on minority ethnic and migrant people has long been recognised as a significant barrier to the full implementation of racial equality. The Southern Area had identified a need for Ethnic Monitoring, recognising the impact of changing demographics and in particular the needs of BME communities living in the area.

As a consequence a local Children’s Services Planning BME Working Group was set up through the Southern Area Children and Young People’s Committee, who in partnership with STEP, WAH HEP and the Legacy SHSSB completed a study into BME access to services across the area and identified a number of key recommendations which were endorsed by Junior Minister Kelly at its launch in 2009 including “the introduction of ethnic monitoring, by the Department of Health, Social Services and Public Safety…”. These recommendations were reinforced at NICEM’s Ethnic Monitoring Seminar in April 2009.

The legacy Southern Area Children and Young People’s Committee, which has since evolved into the regional Children and Young People’s Strategic Partnership (CYPSP), commenced a pilot to address this data gap and improve ethnic monitoring. Following a considerable piece of work, a number of changes have since been, and are being, implemented on Health and Social Care systems:

Universal Community Systems - Hospital Systems – System:- o Social Services Client o Patient  Child Health Administration and administration System Retrieval Environment System (PAS) (CHS) (SOSCARE), inpatients, o Regional Sure Start o Northern Ireland Database Maternity System o Family Support Hub (NIMATS). Monitoring

The Trust welcomes the launch of the guide which will apply to any other HSC system(s) which implements Ethnic Monitoring. These changes aim to help Health and Social Care commissioners and providers to robustly capture critical patient/service user information and through this help Health and Social Care

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organisations to develop and enhance service provision to all members of the community, and respond to the needs of a changing society, and help to ensure that Equality and Human Rights obligations are met.

This ethnic monitoring guide is intended to assist staff working in Health and Social Care in Northern Ireland and is targeted at:

 Frontline staff and their managers who will be responsible for directly asking patients/clients for the information and may need to deal with exceptional or difficult cases;  Clinical, nursing, paramedical and auxiliary staff who may need to know the questions that patients/clients have been asked;  Analytical or information staff who need to know how to use ethnic category data; and  Senior management who may also require to be briefed on the data collection in relation to equality and human rights obligations.

Fields have successfully been implemented onto all the systems highlighted above. The Patient Administration Systems across all Hospitals went live in the last quarter of 2015. Issuing of the guidance and relative materials will help in the implementation of same.

Work is continuing with PMSI around the role for data standards and quality to embed importance of recording. Also the progress of the Ethnic Monitoring Project has been mentioned in the recent OFMDFM Racial Equality Strategy Consultation – http://www.ofmdfmni.gov.uk/racial-equality-strategy-2014-2024- consultation.pdf page 33.

 Roll out of PARIS – Ethnic Monitoring

The PARIS Community Information System which, by providing a fuller profile of each patient in a way that can be shared between community and hospital services, is helping to improve safety and avoid patients having to repeat the same information to different teams.

23 Please provide any details or examples of monitoring that has contributed to the availability of equality and good relations information/data for service delivery planning or policy development:

Examples:  The Ethnic Monitoring Project has helped to identify uptake of services and unmet need for BME communities e.g. the Trust's Local Traveller Action Group and associated action plan and Regional Thematic Group for Travellers – chaired by the Public Health Authority.  Challenges for Rural Minority Ethnic Communities - 8th October 2015 Armagh City Hotel, Armagh - The purpose of the seminar was to facilitate network members and other participants to work through the challenges faced by minority ethnic communities living in rural area across the province. With the lack of available quantitative data the focus of the event

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was to draw out participants’ thoughts and experiences as a minority ethnic person along the following themes: Health & Wellbeing, Employment and Entitlement, and Education and Training. This event was organised by Stronger Together in partnership with the Armagh Craigavon Banbridge Inter-Agency BME Network. 53 participants attended the seminar from across 30 organisations.

Participants heard from Brenda Toal from the Southern Health and Social Care Trust who delivered a presentation on the Hearty Lives Project in the southern area. Hearty Lives is a three year project funded by the British Heart Foundation aiming to improve the Heart Health of Irish Traveller and Black Minority Ethnic (BME) Communities in Craigavon Borough Council area. The southern area has some of the largest population of BME residents in its geographical area. The benefits from the project included increased GP registration, greater awareness of Primary Care and appropriate use of services, greater uptake of lifestyle programmes and reduction in risk factors leading to cardiovascular disease. The learning from this project will inform the new NI Entrants Scheme (NINES) which was launched on 1st June 2016 in South Tyrone Hospital, Dungannon. NINES is aimed at those new to NI not registered with a GP.  NINES will monitor the uptake of their service by ethnicity and provide regular reports to the PHA.  Monitoring of previous Carers Contract has led to the development of a new Carers Contract with input from service users and carers and also the development of a support network for BME carers - whose uptake of this service has been generally low.  Staff monitoring has helped produce real time data to inform future equality screenings and Equality Impact Assessments in determining the impact of service changes on those potentially affected.  Staff monitoring has also been useful to determine any policy gaps e.g. transgender policy.

Staff Training (Model Equality Scheme Chapter 5)

24 Please report on the activities from the training plan/programme (section 5.4 of the Model Equality Scheme) undertaken during 2014-15, and the extent to which they met the training objectives in the Equality Scheme.

In keeping with the commitments in its Equality Scheme i.e. Chapter 5 the Trust has put in place a range of training interventions which has met the training objectives of its Scheme. The Trust is committed to providing learning and development support to all staff. This is illustrated in the Trust values and a range of Human Resources strategies including: Knowledge and Skills Framework (KSF) Appraisals Learning and Development Strategy Succession Planning initiatives and

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Widening Participation initiatives etc. The Trust provides a range of S75 and other equality training, which is available to all staff. Training is advertised to staff via a range of mediums including the Trust intranet, Southern-i, posters, flyers, via line managers, Trade Union and corporate staff magazines and training brochures. Training needs are identified through staff personal development plans etc. Events are also organised on a regional basis such as the S75 and Procurement i.e. ‘Regional Procurement/Commissioning/ Planning Workshop – A Focus on Equality and Human Rights Implications’ to which Assistant Directors of Performance and Reform and Contracts Management personnel were invited. The Trust has also invested heavily in an e-learning staff development system that enables staff to complete an increasing menu of training interventions in line with the Trust's Knowledge and Skills Framework (KSF). Training resources are also kept continually under review to reflect any amendments/developments in the legislative framework and evolving case law. As previously reported, the Trust's Director of Human Resources and Organisational Development and Equality Manager together with the Trust’s Education, Learning and Development Team continually strive to introduce new and innovative ways to challenge mindsets and behaviours in pursuit of the Trust’s aim to further its S75 equality duties.

Trust Equality Scheme – Training Commitments The Trust has committed in its Equality Scheme to the following training objectives:  To raise awareness of the provisions of Section 75 of the Northern Ireland Act 1998, our Equality Scheme commitments and the particular issues likely to affect people across the range of Section 75 categories, to ensure that our staff fully understand their role in implementing the Scheme.  To provide those staff involved in the assessment of policies (screening and EQIA) with the necessary skills and knowledge to do this work effectively.  To provide those staff who deal with complaints in relation to compliance with our Equality Scheme with the necessary skills and knowledge to investigate and monitor complaints effectively.  To provide those staff involved in consultation processes with the necessary skills and knowledge to do this work effectively e.g. via Trust PPI Toolkit and related training.  To provide those staff involved in the implementation and monitoring of the effective implementation of the Trust’s Equality Scheme with the necessary skills and knowledge to do this work effectively.

There follows a summary of the main training interventions for HSC staff in support of the commitments in the Trust's Equality Scheme outlined above:

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Awareness Raising Trust Board and Senior Management Team Specific guidelines for Trust Board members have been devised to highlight the importance of mainstreaming the S75 equality duties into the day to day business functions of the Trust, together with the implications of the S75 equality duties for policy development, corporate planning and decision making processes; the renewed emphasis on addressing inequalities and achieving outcomes for S75 categories etc. It further highlights the importance of leadership and top-level commitment to ensure the effective mainstreaming of the duties. This resource will be updated to reflect the outcome of the Equality Commission’s own research into the out workings of the S75 Equality Duties and any subsequent advice on consultation time frames as a consequence of Clause 65 of the Fresh Start Agreement The Trust’s Equality Scheme has been aligned with the Trust's corporate planning cycle to further facilitate the mainstreaming of the S75 equality duties). In addition, Trust Board members and Senior Management Team receive regular updates on the promotion of equality of opportunity and good relations duties along with a comprehensive overview on performance through the S75 annual progress report. The Trust's SMT and Trust Board also receive regular updates on equality screenings and EQIAs conducted on key service developments ahead of public consultation. The Trust’s SMT and Trust Board sign off on EQIAs before and after public consultation. Notable examples during the current reporting period include the 'Proposal for the Future of Statutory Residential Care for Older People' and the equality screening on the 'Proposal for the Closure of the Minor Injuries Unit in Armagh.' Other worked examples include the public consultation on the Trust’s Strategic Plan – Improving through Change 2015- 2018 and cumulative equality assessment of the Trust’s Financial Plan for 2015/16.

Corporate Induction Training Training for all new staff (through the Trust’s Corporate Induction Programme) includes the Trust’s equality duties and commitments in its Equality Scheme. In addition, to having access to a copy of the Trust's Equality Scheme, the Trust has produced an information booklet for all staff entitled ‘Trust’s Equality Scheme – What it means for Staff’ which is available on the staff intranet. The booklet provides a simple overview of the S75 equality duties and what it means to staff in their day to day work. The Corporate Induction Programme is provided in-house and is also extended to all trainees and those on placement e.g. Steps to Work - long-term unemployed, disabled persons under the Trust’s Placement Policy, Graduate Acceleration Programme (GAP) etc. Participants are also sign-posted to the Trust’s Discovering Diversity e-learning modules which they are asked to complete as part of the Knowledge and Skills Framework (KSF) – equality being one core element/competency.

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Professional Induction Programme for Social Work/Care Staff & Social Work Students Provision of equality training for newly qualified nursing and social work staff is delivered in-house via existing equality and Social Care Training Unit staff. Induction programmes are held twice a year in January and September. As part of this training event the Equality Unit provides a module entitled ‘Equality and Human Rights Awareness’. This presentation provides participants with an overview of what is expected of them as employees of the SHSCT with regards to equality and human rights issues when working alongside colleagues and when in contact with service users. Topics covered include What is Equality?, Protected Grounds, Forms of Discrimination, Challenging Stereotypes, S75 equality duties and key elements of the Trust’s Equality Scheme. In addition the Trust’s Values, the effective and efficient use of the Northern Ireland Health and Social Care Interpreting Service, overview of the Multi-cultural and Beliefs Handbook – Resource Pack for Staff, Legislation and Key Policies and Resources are all addressed. This programme is organised to meet induction standards set down by NISCC as well as the mandatory training standard set by the Trust. The programme draws on the input from staff within the Trust as well as external providers. For example, the induction programme includes input from Travellers, Legal Services e.g. BSO and Law Centre etc. As with previous sessions the overall evaluations were very positive ranging from very good to excellent.

Medical Staff The Medical Directorate’s Southern Docs website also contains sections on junior doctor induction, medical appraisal and revalidation together with other aspects of medical training. It also includes links to the Discovering Diversity e-learning modules, Vulnerable Adults and Child Protection Training etc. Completion of the Discovering Diversity e-learning modules is mandatory in line with revalidation requirements for all medical staff.

Discovering Diversity E-Learning Modules The Discovering Diversity E-Learning platform now extends to 7 modules and acts as the main medium for raising staff awareness of the Trust’s equality duties, human rights obligations and disability duties as it relates to all functions undertaken by the Trust i.e. employment, service provision and procurement. The modules have been designed to satisfy the core equality competency set out in the Knowledge and Skills Framework. Staff are able to create their own unique username and password which the programme will recognise each time they return to complete each module at their own pace. Staff are also encouraged to complete the short end of module evaluation which enables the Trust to take on board staff comments and any suggestions for improvement in future revisions/editions. Each module also includes a self-assessment element whereby staff can generate

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their own certificate of completion as evidence for their own personal development portfolio. Work commenced during the year under review between HSC Trust Equality Leads and Aurion software provider with a view to creating 2 new modules, one for all staff to complete and one for managers to complete which includes a managerial dimension. These new modules will include a focus on a human rights based approach to HSC; and further strengthen the good relations and S75 equality duties. It is essential that staff complete their e-learning modules. Timely reminders are issued via the Trust Southern-i (corporate news sheet) and global communications – see below: Have you completed your essential Discovering Diversity E-Learning Modules? As part of the Trust’s ever expanding diverse culture, a series of e-learning modules are available to help keep SHSCT staff informed and equipped to deal with this diversity whilst in the workplace. Seven Discovering Diversity Modules have been developed to allow staff to educate themselves through an interactive forum. The range of modules include:  Modules 1-4: Give an overarching view of diversity including Exploring Fairness; Understanding Prejudice; Dealing with Difference and Making Difference Work.  Module 5: Disability.  Module 6: Cultural Diversity.  Module 7: LGB&T (Lesbian, Gay, Bisexual and Transgender) (Developed by the Public Health Agency). It is essential that all staff complete the Discovering Diversity E-Learning Modules as part of their KSF pathway and the modules can be accessed via the following links: For Modules 1-6  For access within the Trust: http://diversity.hscni.net  For access outside the Trust: http://www.diversity.hscni.net/

For Module 7  Access is via: http://www.lgbtelearning.hscni.net/

Quarterly reports are produced for each directorate to establish the uptake by staff of these modules.

Diversity Awareness Training – Business in the Community The Trust also links in with Business in the Community to provide face to face workshops on Diversity Awareness Training aimed at Trust managers and employees. Workshops examine diversity and inclusion in an open and safe way through a series of interactive and participative sessions. Participants examine and challenge personal views and perceptions and the impact behaviours can have on others and the organisation in the moral, business and legal context. The main objectives are as follows:  to increase awareness of diversity in the workplace and the value in

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creating an inclusive workplace;  to help employees and managers recognise personal prejudice and organisational responsibilities in relation to building an inclusive working environment;  to understand the relationship between equality and diversity;  and to understand the impact of exclusion. Overall evaluations on exploring prejudice, challenging stereotypes, understanding diversity and interactive case studies were excellent. Further sessions are planned. A further 1741 staff completed this training during the current reporting period.

Human Rights Training The Trust's Social Services Workforce Development & Training Team continued to provide Human Rights training for social care staff during the year under review. Human Rights training is in the main delivered to Trust staff by the Directorate of Legal Services from within the Business Services Organisation. Topics covered include working with new arrivals to NI in the Health and Social Care system i.e. access rights/entitlements, duty of care as well as general human rights training but with a particular focus on a HSC context. Human Rights Training - uptake 04/11/2015 – 15; 25/1/16 – 22; 28/1/16 – 18; 12/2/16 - 20

Policy Screening and EQIA – Skills Training The Trust’s Head of Equality continues to deliver S75 Equality Screening and Equality Impact Assessment training to policy authors and decision makers within the Trust. Notable examples, during the year under review, included the screening of the Trust’s Financial Plan – cumulative assessment; equality screenings of the Trust's contingency proposals; the Proposal for the Future of Statutory Residential Care for Older People (EQIA); the Proposal for the Closure of Armagh Minor Injuries Unit. The Trust’s Equality Manager provides ongoing advice and support in the discharge of the Trust’s S75 statutory equality duties and acts as a business partner in support of each programme of care/service directorate. Training is usually a half day and can take the form of specific workshops with a particular focus like those hosted for TYC and more recently those in preparation for the aforementioned EQIAs. In addition, screening and EQIA guidance along with worked examples is made available to staff to support them with equality screening and EQIA processes. As reported above the equality screening template will be reviewed taking into account the learning from the pilot together with the findings from the research conducted by the Equality Commission into the worked experience of Public Authorities of equality screening and EQIA processes. Training materials will be reviewed accordingly.

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BME Mental Health & Wellbeing Pilot

The Stronger Together Network has been awarded a PILOT Service to support Mental Health and Wellbeing of Minority Ethnic communities across NI. The project is funded by the Public Health Agency (PHA).

The project’s initial year is research, training and development focussed, leading to the design and delivery of a new evidence-based pilot programme.

To ensure the success of the pilot the project requires significant input at all stages from individuals within the black and minority ethnic (BME) communities who have had experiences, either as providers or service users, of mental health service provision. Aware Defeat Depression are partnering Stronger Together to deliver the appropriate training.

The Mental Health First Aid Course teaches participants how to recognise the symptoms of mental health problems; how to provide initial help and how to go about guiding a person towards appropriate professional help. Participants that avail of this funded training will have an on-going responsibility to the overall project which is due to complete March 2018. This will include promoting and encouraging participation in the Mood Matters Course to individuals within the community in which they work; to refer individuals to the course where appropriate and to contribute their experiential knowledge toward the research element of the project.

Community Contract Awareness Training

Community Contract Awareness Training sessions took place on 18 Sept, 21 Sept and 5 October 2015. These sessions included S75 equality duties and where delivered by staff in the Trust contracting department.

Staff involved in Consultation Processes - Skills and Knowledge Training PPI is a standing agenda item on the Trust Patient Client Experience Committee which is a subcommittee of the Board who reports directly to the Trust Board. Each Trust Board meeting has an agenda item which focuses on a patient/client centred service which includes feedback and learning from PPI activity. There are now 4 PPI Panel representatives on the Patient Client Experience Committee (subcommittee of Trust Board that provides corporate leadership on matters relating to PPI and Patient Client Experience). The 4 PPI panel representatives are full voting members. Directorate leadership arrangements are and a PPI contact/lead has been appointed in each Division/Directorate.

Each Directorate is required to compile a register of individuals interested in being involved to disseminate engagement opportunities. The Trust’s website/Facebook also promotes opportunities and acts as an important medium to reach out to a wide range of stakeholders. The Trust has also developed a mailing list which includes the community/voluntary organisations and disseminates opportunities for onward circulation to constituent members on behalf of the Trust. On line

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registration is available on Trust website. A central register of longstanding service user/carer groups/forums is appended to the Trust’s Consultation Scheme and is available on Trust website. In addition, the Equality Unit keeps under review its master consultation list to ensure that it is as up-to-date as possible to facilitate all future engagement and consultations. During the year under review the Trust undertook a self-audit checklist exercise to determine the level of compliance (against the PPI indicators) across all Trust Directorates. The results of this exercise were made available in March 2016. The audit indicated areas where teams were compliant and identified where additional support is required.

Actions from the self-audit will be taken forward and reflected in the Trust Equality Scheme Action Based Plan 2017-2022.

Practical steps undertaken in the last 12 months to facilitate and support the involvement of service users, carers and the public (in particular marginalised/excluded/S75 groups) in the planning, delivery and evaluation of services:

 Good Meeting Etiquette checklist developed in partnership with PPI Panel and displayed on Trust desktops. Good Meeting Etiquette posters have been developed and forwarded to Support Services for display in Trust meeting rooms.  Good Etiquette pop-up stand purchased  Have Your Say pop-up stands ordered for display in foyer of main hospitals  PPI flow chart revised as part of up-dated Consultation scheme  Opportunities for involvement template developed for longstanding service user/carer groups forums for inclusion in up-dated Consultation scheme and Trust website  Recruitment drive for PPI Panel and Carers Reference Group  Translation of information and leaflets  Use of interpreter services- SHSCT is the highest user of Regional Interpreting Service  Self-Directed Support extended to carers  In 15/16 Learning Disability increased funding for Advocacy Services by 50%  Each ward/unit in CAH has a ‘Welcome Board’ with an information leaflet rack  Butterfly scheme – progress is detailed in Part B of this year’s S75 APR.  PACE - this person centred approach that respects and empowers, will promote partnerships and focus on prioritising people and their families/carers. Staff will be able to recognise and respect the contribution to care and ultimately it will promote the ethos of ‘contract of care’ with the patient - consent, understanding of care/treatment  ‘This is me’ – a simple and practical tool that people with dementia and learning disability can use to tell staff about their needs, preferences, likes, dislikes and interests.

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The Trust’s PPI Annual Report provides an overview of PPI activity. In addition there are a number of news sheets that provide information and feedback on key themes e.g. the PPI Carers Summary flyer is available on the Trust’s website as is the PPI Traveller Summary and Traveller Progress Newsletter. Further, there are a variety of service newsletters e.g. ICT Newsletter, Recovery Newsletter, etc. A new section has also been included in Leadership Walkabout Tool to ask how staff involve service users and carers. A similarly section will also be included in the Trust’s revised Equality Screening template.

PPI Awareness Personal and Public Involvement training continues to be delivered across the Trust, at team meeting level and as part of core induction. An extensive range of PPI tools have been developed to support staff with the effective roll out of its PPI and S75 equality duties and to further enhance and develop the skills and confidence of staff. Service users and carers are involved in the design, delivery or evaluation of PPI training. For example:

 PPI Panel members are involved in up-dating in house PPI Awareness  PPI Panel members were involved in Public Health Agency E Learning pilot  PPI Panel members are members of the Regional PPI Forum training subgroup and were involved in the development of Engage and Involve programme  PPI Panel members were also involved in the planning, design and delivery of PPI workshop ‘Quality Event Workshop’ in October 2015.  The Mental Health Core Care Pathway staff awareness sessions were co- developed with User, Carer Service Improvement Group (UCSIG). In-house PPI Awareness training continues to be delivered at Team meetings and as part of the core induction programme for Social Work students twice yearly. The training was revised in May 2015. There follows summary details of the level of PPI awareness training delivered during the current reporting period:  PPI Awareness delivered to student social workers at core induction programme August 2015 and Jan 16. 71 students and 30 new staff members and at team meetings to existing staff:  15/04/15 Brain Injury team – 6  13/06/15 QUF Physio Assistants – 8  15/06/15 Community Midwives – 10  28/06/15 Children’s Development clinic staff – 12  15/09/15 Professional Development Prog For Nurses & Midwives – 11  25/01/16 School Nurses Speakers Meeting - 30  Leadership Within -2 workshops 54 staff OPPC Sept 15  CIT – Quality Improvement E learning pilot (PPI section) 30 staff  How to involve service users and carers workshop (x2) at Quality Improvement Event 14/10/15 - 43  Regional PPI Awareness E learning pilot Oct 2015 (9 staff and 4 Panel

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members)  Engage and Involve – PPI Coaching pilot – 11 staff- T4T – 4 staff  Mental Health Core Care Pathway staff awareness sessions co-developed with UCSIG. 100+ staff trained.

Total number of Trust staff receiving PPI training @ 31/1/16 = 1192 Total number of students receiving PPI training = 381 Total number of Volunteers receiving PPI training =13 Overall total @ 31/1/16 = 1586 The Trust will continue to cascade the roll out of PPI training as required for staff within available resources and in line with the Trust’s Training and Development Strategy. The Public Health Agency has confirmed that a Business Case has been made to DHSSPS Feb 2016 for further funding. Members of the Trust’s PPI Panel sit on the Regional PPI Forum and these representatives and other service users and carers from the Trust have participated in the development of the regional PPI training strategy and pilot training programme development. The Trust’s PPI Team have also worked with staff, service users and carers from the PPI Panel and others to develop a range of resources to assist with raising awareness of PPI organisational and individual responsibilities amongst staff and to support staff and service users and carers in implementing PPI effectively. Such measures include: A Directorate Action Plan template is in place to focus staff along the following key themes:  Information  Service User and Carer Involvement  Evidencing Patient & Client Experience Standards  Training  Monitoring and Evaluation PPI indicators have been developed for each of the above five key themes.

Community Development Training The Southern Health and Social Care Trust’s Promoting Wellbeing Improvement Department seeks to improve the health of the Southern Trust population and reduce inequalities in health between geographical areas, socio economic and minority groups. The Promoting Wellbeing (PWB) Division works in partnership with a wide range of community, voluntary, statutory and public sector agencies to maximise health and wellbeing. The PWB Division also works across Trust Directorates to embed health and wellbeing improvement into Trust policy, processes and delivery of services and care. A key role of the Division is to build the skills and capacity of others to promote health and wellbeing and tackling inequalities. Community Development Training includes: -  Community Development Awareness  Community Development Approaches with Children and Young People.

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Complaints Management On-going training is provided to staff who deal with complaints management and the relationship this has with the Trust’s Equality Scheme so that complaints managers and staff have the necessary skills and knowledge to investigate and monitor complaints in a timely and effective manner. At the time of completing this year’s annual progress report HSC Equality Leads were exploring the feasibility of collaborating with the NI HRC in exploring a human rights based approached to complaints management framed around the FREDA values and principles.

Monitoring To support staff involved in the implementation and monitoring of the effective implementation of the Trust’s Equality Scheme a range of tools have been developed such as the Themed Inequalities Audit on which to bench mark progress; Development of Ethnic Monitoring Guidelines for use by the HSC sector on existing and any new system developments/enhancements, associated Guidelines for staff and Ethnic Monitoring posters to promote the value of S75 monitoring. The importance of S75 monitoring has also been augmented into Quality Data Training for all staff. Further, the HRPTS electronic staff management system provides for ‘employee self-service’ whereby staff can update any changes to their equality and diversity data - thus providing for real-time data to inform e.g. equality screenings and EQIAs. Supporting guidelines have been developed to support staff with the deployment of this relatively new system along with designated staff to provide ongoing help and support. The Trust also draws on the ECNI Guidelines on monitoring and looks forward to receiving a copy of the Commission’s next edition of ‘Key Inequalities in Health and Social Care’ to update its own themed inequality audit which will be used as a basis to inform its next S75 Action Based Plan.

Procurement A regional workshop took place on Friday 14th August 2015 to which a wide range of HSC staff from across the HSC sector were invited. The workshop was hosted in fulfilment of one of the regional commitments in HSC Trusts’ Equality Scheme Action Based Plans i.e. action measure no 20 refers. The focus of the workshop was HSC Procurement Commissioning and Planning – Human Rights and Equality Implications – Good Practice in Procurement and Contracts Management. 31 people attended and 22 filled out the evaluations. 100% stated that the course was relevant to their work and similarly 100% stated that there was useful learning from the course. The following elements were found to be the most interesting:

 Pre-Procurement decision making  Links to Human Rights and Section 75 with Procurement  Good Practice in Procurement  Overview of Legal Requirements  All useful and thought provoking  All aspects

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 Case Study  Consultation  Sharing and getting together

All participants stated that they would recommend this course to their colleagues.

Employment Selection and Recruitment Training The Trust has in place arrangements to ensure recruitment panels receive training on the Trust’s procedures for ensuring a fair selection process. A regional e- learning platform has also been development which is used for refresher training. Current equality law and best practice is incorporated as part of the overall assessment.

Peer Learning Sessions Peer Learning Sessions were arranged as part of the HROD Succession Planning Programme. All staff within HROD are invited to attend the Peer Learning Sessions on topical issues. These sessions routinely include a legal dimension covering key developments in the sphere of employment equality law.

Training Resources A number of in-house leaflets and documents have been produced to increase staff awareness of equality and diversity matters and to promote cultural competence e.g. Multi-Cultural and Beliefs Handbook, Cultural Diversity and Etiquette Booklets, Traveller Information Booklet, Disability Etiquette Booklet, Making Communication Accessible for all, PPI Fact sheet on “Working with Hard to Reach Groups”, Carer and Stakeholder Reimbursement Guidelines and Procedures and PPI Toolkit to support staff in promoting inclusive user involvement. Some of the aforementioned resources were reviewed and updated during the current reporting period. During the year under review the Trust’s Traveller Information Booklet for staff was updated by the Trust’s Equality Unit to reflect the findings of recent studies and updated statistics. The Booklet aims to increase staff awareness of Traveller culture and enable staff to provide culturally sensitive services. The Booklet is available to all staff via the Intranet. As evidenced in this section, of the year’s S75 annual progress report, there are a range of management development initiatives which reflect and build upon the patient/client standards and underpin the Trust’s core values which have been founded on the principles of equality and diversity i.e. treating people with dignity and respect, protecting their privacy, communicating in a manner that is sensitive to their needs, and showing professional and considerate behaviour toward patients and clients at all times. There are also a number of supporting policies/procedures/guidelines that relate to equality and diversity namely the Trust’s Equal Opportunity Policy, Harassment at Work Procedure, Working Well Together Policy. Other examples include the Trust’s Harmonious Working Environment Guidelines and Joint Declaration of Protection all of which are kept under review in line with Fair Employment and

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Treatment (NI) Order (FET0) requirements and evolving legislation and case law developments.

Good Relations Training Traveller Health Champions and Health Trainers During 2015/16, the Trust secured funding from PHA to employ a Health Training Coordinator to develop a programme of accredited and non-accredited health and wellbeing training for Travellers. 16 Travellers completed Community Health Champion training accredited at Level 2 OCN and 1 completed Community Health Trainer training accredited at level 3 OCN. All participants received a range of non-accredited wraparound support training to meet their individual needs and equip them to volunteer as Community Health Champions within the local community and to be paid a sessional rate for their work as a Community Health Trainer. A further business case has been submitted and funding has been extended for a further 2 years to provide further support and mentoring to those trained - to embed, test and extend the model. It is anticipated that this model will assist in further raising awareness of the benefits of breastfeeding, screening, immunisation and making healthy lifestyle choices and increase understanding in the Traveller community about Trust services and referral pathways and ultimately reduce health inequalities. SHSCT - Traveller Cultural Awareness Workshops  February 2015-Midwives/Health Visitors, CAH (37)  February 2015-Midwives/Health Visitors, DHH (10)

Community Health Champion Training 8 Travellers from the Dungannon and Coalisland areas completed Community Health Champion Training delivered by the CDHN (Community Development & Health Network). Facilitation Skills for Community Health Champions, is a 3 day accredited training programme which combines 2 OCN Units (Community Health Champion & Groupwork skills). The training took place on 19th, 20th and 24th of August in Western House, Coalisland. The Learning Objectives of Community Health Champion Training ensure that:  Participants understand the social model of health and  How social determinants affect health both directly and indirectly  Participants will be challenged to explore their personal values and to reflect on what qualities and resources they bring to their new role  Participants will understand the values and principles of community development and its effectiveness in tackling health inequalities  Participants will improve their health literacy  Participants will gain an understanding into the benefits of working collaboratively  Participants will feel confident to use their knowledge and life  Experience within the role. Another course was run in the Newry area autumn 2015.

Anti-bullying The Belong Programme aims to promote a sense of belonging for BME children

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and young people (aged 7-12 years) across Northern Ireland, with a practice base in the Southern area of NI. Key intended outcomes are as follows: to increase cultural confidence and competence; increase participation in schools and clubs; increase educational achievement of Traveller children; to reduce bullying and racial-bullying and to increase resilience. Belong offer a range of free workshops and training sessions that explore the issues of bullying and racial bullying. They provide training for parents, practitioners working with children and young people including school and community professionals. Practical advice and relevant information on all aspects of bullying are delivered to meet the needs of the group. Topics include:  Defining bullying – including racial bullying  Indicators of bullying  How to prevent bullying  Role and responsibility of the NI education system  How and where to get help with bullying. For practitioners working with children and young people Belong offers a 2-hour or full day programme which is facilitated from a rights based perspective. The session covers the following key areas through interactive and discussion based activities:  Defining and understanding bullying behaviour  Racial bullying  Legislation and policy – N. Ireland context  Effective responses to bullying behaviour.

Developing Cultural Competence – Staff Resources Service users who are not proficient in English or who are new to NI should be able to access a culturally competent and responsive service. This toolkit is designed to assist mental health practitioners meet this need. Delivering mental health services can be complex, but this becomes even more difficult when we add cultural and linguistic differences. In 2013 the Public Health Agency (PHA) provided funding on a regional basis specifically to examine how HSC mental health providers could be supported in the delivery of culturally competent services. Aware Defeat Depression worked in partnership with Health and Social Care Trust representatives to look at how best to support this initiative. This partnership convened a regional conference in June 2013 for mental health specialists across the statutory, community and voluntary sectors. The focus of this event was “Developing Cultural Competence when delivering Mental Health Services to Black and Minority Ethnic Communities”, which looked at the complexities of delivering mental health services in this context. This toolkit is the result of the conference and is now available for staff on the Trust's intranet. The toolkit is broken down into quick reference sections with hyperlinks to more detailed reports or useful resources and there are a number of appendices with useful links. In support of the roll out of this toolkit staff training sessions were offered to HSC

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staff i.e. 2 x ½ days which were held on 15th and 22nd October 2014. There were 4-5 places allocated to each HSC Trust. In addition training for trainer’s session was held on 11th December 2014 to train up staff so that they are self-sufficient to deliver these sessions in the future and in order to ensure the sustainability of this programme. To support the training sessions and the roll out of the toolkit a cultural competency DVD has also been produced. The DVD was produced by The Production Company, who have worked extensively in health and social care in the past.

Working Well with Interpreters - Staff Training Sessions During the year under review Working Well With Interpreters Training sessions continued across the Trust facilitated by the NI Health & Social Care Interpreting Service (NIHSCIS). Each half hour session was designed to raise awareness of the NI Interpreting Service, the role of the interpreter, patient rights and entitlement to language assistance, the risks/dangers of using untrained Interpreters/family/friends. At the close of each session participants had a greater awareness of systems and procedures for booking interpreters and when it is appropriate to use face to face v telephone interpreting. Uptake was very good across these sessions. Evaluations were also very good e.g. “Very informative, will be able to put information gained today into practice”, “A very good, informative session”. In addition, the Manager of the NI HSC Interpreting Service ran interpreting engagement sessions to familiarise HSC staff with the new IT portal system that will came into operation autumn 2015. This new on-line web-based portal had already led to further improvements in the booking arrangements and the production of real-time management information. Engagement sessions were also hosted across all HSC Trusts see details below: Session Location Session Date Session Time Classroom, Nurses Home 11th February 10.30am – Daisy Hill Hospital, Newry 2016 11.30am Classroom, Nurses Home 11th February 12.00noon – Daisy Hill Hospital, Newry 2016 13.00pm Boardroom, SHSCT HQ 19th February 14.00pm – 2016 15.00pm Boardroom, SHSCT HQ 19th February 15.15pm – 2016 16.15pm Parent Craft Room 26th February 10.30am – Maternity Unit, CAH 2016 11.30am Parent Craft Room 26th February 12.00noon – Maternity Unit, CAH 2016 13.00pm Lecture Theatre 8th March 2016 14.15pm – South Tyrone Hospital 15.15pm Lecture Theatre 8th March 2016 15.30pm – South Tyrone Hospital 16.30pm

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In addition 3 engagement sessions were also held to raise awareness of the transition arrangements to the new web based portal.

 Provision of Interpreting Service The Southern Trust has one of the largest ethnic minority populations in Northern Ireland and our overall population is projected to grow by 13.5% by 2020. Our ethnic minority population is also likely to increase significantly by 2020 as birth rates continue to keep growing.

Provision of language assistance is a legal requirement for public sector organisations and as an essential part of providing safe, high quality care to all patients and clients. The Trust is committed to ensuring everyone is given equal access to information about services in a format they can understand. The Trust provides interpreting services on request to help patients and clients and staff to communicate when using services.

Interpreters are provided and funded regionally through the Northern Ireland Health and Social Care Interpreting Service. Interpreters are professionally trained and adhere to a Business Services Organisation Terms of Engagement for Interpreters. The Terms of Engagement outlines HSC Interpreters key roles and responsibilities when undertaking work through NIHSCIS.

Interpreters are bound by confidentiality and provide their services on a 24/7 basis. NIHSCIS has 300 Interpreters registered in 36 different languages.

Demand for Interpreting continues to increase on an annual basis with over 98,000 requests for Interpreters processed during 2015-16 and 97% of bookings successfully fulfilled.

Key Achievements and Developments in 2015-16 The new HSC online Interpreting booking portal went live on 20th January 2016 following successful implementation across the 5 HSC Trusts and GP Services. To date more than 10,000 HSC Staff and Practitioners have registered to use the system and across the region over 54,618 bookings have been submitted for appointments up to December 2016.

Professional Development Training for Interpreters HSC Trusts are also providing training for Interpreters who work in the NI Health & Social Care Interpreting Service. The NIHSC Interpreting Service are in the process of upgrading all registered Interpreters to OCN Level 4 standard. The upgrade consists of 4 sessions in Maternity, Mental Health, Social Services/Domestic Abuse and Speech and Language Therapy.

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Interpreters must attend all 4 training sessions in order to achieve Level 4. 71 Registered Interpreters have upgraded to date. The sessions are also required as part of the NIHSCIS OCN Level 4 and Conversion Course Training for new Interpreters joining the NIHSCIS Register (needs only basis). BSO are currently investigating the possibility of setting up SLA’s with Trusts to formalise training to be delivered by:  Southern Trust: Maternity  Belfast Trust: Speech & Language Therapy  Northern Trust: Social Services (in conjunction with Women’s Aid)  South Eastern/Western Trust: Mental Health BSO are keen to have formalised agreements in place with each HSC Trust in order to ensure high quality safe services.

End of Life and Organ Donation – Workshop for NI HSC Interpreters – Raising Understanding for BME communities. Over 20 experienced interpreters from the NI HSC Interpreting Service team attended an information workshop on ‘End of Life Care and Organ Donations’ during the current reporting period. The session outlined for interpreters the important elements of end of life care and information that they may be required to explain to dying patients and/or bereaved relatives. The day was essentially aimed at helping interpreter’s understanding of what is/has/should happen at end of life so that they can fully contribute to the process when providing interpreting support for patients and their relatives. The Bereavement Co-ordinators were Anne Coyle (SHSCT) and Heather Russell (BHSCT) – both very experienced HSC practitioners. It is intended to roll out this session to more interpreters in the future as there is a general lack of understanding amongst the BME migrant community about practical end of life issues and organ donations.

Adult Safeguarding awareness training The Belfast HSC Trust Social Work Training Team delivered Adult Safeguarding awareness training sessions to HSC Interpreters in March and April 2015.

Brief Intervention in smoking cessation Training Cathy Murray Southern Trust Health Promotion Facilitator & Stop Smoking Specialist Promoting Wellbeing Team provided training to 24 HSC Interpreters in 2015/2016.

Stillbirth and Neonatal Death Interpreter Training SANDS (Stillbirth and Neonatal Death Charity) are currently working with NIHSCIS to devise a training programme for Interpreters. This training is due be delivered in 2016/2017.

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NI Blood Transfusion Service NIBTS are currently working with NIHSCIS to devise a training programme for HSC Interpreters working with BME migrant communities. This training is due be delivered in 2016/2017.

English Classes Available in Southern Area Craigavon Intercultural Programme (CIP) provides language training for the general community in the Southern area. Having been awarded PEACE III funding, CIP deliver a series of language and cultural classes in three of the main languages spoken in the Southern area, i.e. Portuguese, Lithuanian and Polish in partnership with the Southern Regional College.

Visual Awareness Training and Guiding Techniques (VAT) The Trust has a contract for Visual Awareness Training with RNIB. Danny McSherry, RNIB NI Community Vision Coordinator, provided training, during the current reporting period, to support Trust staff working with people with sight loss. The course covers communication skills, guiding skills, guide dogs, the Disability Discrimination Act and group work. Target Audience: Anyone involved in assisting and supporting blind and partially sighted people. Objectives of Training: To give a better understanding of issues associated with sight loss. To give statistics on a number of areas of sight loss. Dispel some myths surrounding sight loss. Demonstrate the correct way to guide a person who is blind or partially sighted. Enable participants to begin to think about issues around society and people with sight loss Training Outline: Quiz Basic statistics about sight loss and eye conditions Practical using simulation specs Communication: face to face Guiding Skills/ Exercises – practical work in pairs with blindfold Guide dogs and Disability Discrimination Act Group work scenarios Questions and answers Leaflets/booklets on guiding etc. The sessions normally last two and a half hours. In the year to date training was delivered to 590 participants. Feedback received was very positive. Two of the

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Trust's Community Access Support Workers provided 20 training sessions with 171 participants. Excellent evaluations were received by the Sensory Impairment Team.

Learning Disability Master Class 90 community and hospital staff attended a master class on enhancing palliative and end of life care for people with learning disabilities. The event was supported by Macmillan Cancer Support. Aileen Mulligan, Macmillan Palliative Care Service Improvement Lead, outlined the strategic developments in palliative care, and the speakers were Angela McVeigh, Director of Older People and Primary Care Services; Vivienne Williamson, Speech & Language Team Manager; and Bronagh McKeown, Head of Disability Support Services. Dr Dorry McLaughlin, Lecturer in Palliative Care and Chronic Disease at Queen’s University Belfast; and Professor Owen Barr, Head of School of Nursing at the University of Ulster also addressed the attendees.

Sensory E-learning Training Programme As part of the on-going work of the Regional Physical and Sensory Disability Strategy a Sensory E-learning training programme has been developed by the Leadership Centre. Various staff from the SHSCT (Collette Bigley, Hearing Disability Services Manager, Ray Maxwell, Sensory Disability Team and Frances Steenson, Social Worker) participated in the pilot training to help shape and inform the final content. This programme will be widely available to HSC staff. See Part B –Progress on implementing the Disability Duties for details of other disability awareness training.

Trust in the Community – Training for the Community and Voluntary Sector Through the ‘Trust in the Community’ initiative, the Human Resources Directorate continue to reserve places on a variety of Trust training programmes for local community and voluntary organisations. The courses in this initiative include, for example, Moving and Handling Training, Management of Violence and Aggression, e-learning programmes on a range of topics (such as Infection Prevention and Control, Safeguarding People, Discovering Diversity etc.) and level 2 Induction Certificate in Adult Social Care etc.

Putting People First – Ambassador Training This one day programme provides staff with the knowledge and skills to become a Putting People First Ambassador within their Trust/Organisation. The learning outcomes include:

 gaining a better understanding of the importance of how staff attitudes and behaviours towards each other can impact on others  exploring and practicing some of the skills around dealing with service

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users  a clear understanding of the DHSSPNI five patient and client experience standards – e.g. privacy, dignity, respect etc  gaining learning from exploring complaints/difficult situations  examining real life experiences, reflecting and making recommendations for improvement  opportunities to reflect on your own practice and learn from others.

The programme is geared toward staff currently delivering customer care or patient experience programmes or for those aspiring to be involved in similar type work. This is a 1 day programme with 2 or 3 support workshops throughout the year.

Examination of the reasons behind complaints revealed that they are often routed in staff attitudes and behaviours.

25 Please provide any examples of relevant training shown to have worked well, in that participants have achieved the necessary skills and knowledge to achieve the stated objectives:

Regional Procurement Workshop referred to response to question 24 above – aimed at extending best practice across the regional in relation to the mainstreaming of S75 Equality Duties, the Disability Duties and Human Rights obligations. Putting people first – which examines attitudes and behaviours which impact on the patient experience. Face to Face Training on the S75 equality duties – which provides for open discussion and dialogue around pertain issues.

See also response to question 26 below:

Public Access to Information and Services (Model Equality Scheme Chapter 6)

26 Please list any examples of where monitoring during 2014-15, across all functions, has resulted in action and improvement in relation to access to information and services:

 Access to Healthcare – Training has been rolled out during this current and next year’s reporting period on eligibility to healthcare. This training was delivered by the BSO. The training and supporting guidance is aimed at assisting HSC staff in identifying people accessing secondary care services who may be chargeable. In designing this pilot, the Access to Health Care Team considered such issues as Equality, Human Rights and Data Protection. Equality Screening was undertaken early in the development of the proposal where mitigation and positive action have been included in the process. The pilot will be carried out over a twelve month

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period in order to gather sufficient data to evaluate and determine the effectiveness of the proposed processes and to further inform the equality screening.

Access to assessable information. Examples of translations undertaken during the year under review:  Stop Smoking Information Leaflet – translated into a range of ethnic minority languages.  Self Directed Support Practitioners Guide – translated into a range of ethnic minority languages.  Blind cord strangulation accidents - A leaflet from the British Blind and Shutter Association (BBSA) explaining about the dangers, new legislation around manufacturing standards and solution to preventing blind cord strangulation accidents among babies and young children has been translated into a number of minority ethnic languages as follows: Cantonese ,Hungarian, Lithuanian, Mandarin, Polish, Portuguese, Romanian, Russian, Slovakian and Tetum. A video was also produced to raise awareness of the danger of blind cords.  Water Safety Leaflet (Drowning Prevention - Babies and Young Children) – translated into Slovak, Lithuanian, Russian, Tetum and Polish etc.  Access to Health and Social Care Booklet – for those new to NI – translated into 10 Minorities Ethnic Languages.  The Carers Information Booklet and Carers Assessment leaflet developed in partnership with local carers has been translated into 12 different languages and made available in hard copy to all Programmes of care, BME support organisations and community outlets. Local carers were also consulted on the new tender specification for generic carer support services across the Trust area. The procurement process is in its final stages and a new provider was due to be appointed from April 2016. S75 equality duties were mainstreamed within the procurement process.  Fire Safely Leaflet – developed for the Traveller Community.

Complaints (Model Equality Scheme Chapter 8)

27 How many complaints in relation to the Equality Scheme have been received during 2015-16

Insert number here: 0

Please provide any details of each complaint raised and outcome:

Section 3: Looking Forward

28 Please indicate when the Equality Scheme is due for review:

2017

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29 Are there areas of the Equality Scheme arrangements (screening/consultation/training) your organisation anticipates will be focused upon in the next reporting period? (please provide details)

Development of a new Equality Strategy and associated Action Based Plan covering the Period 2017-2022. Development of a new Disability Actin Plan covering the same Period 2017- 2022. Finalising engagement and consultation arrangements in the autumn to facilitate user input in the development, implementation and review of the above plans. Development of 2 new Discovering Diversity E-Learning module for management and staff Reviewing the Trust equality screening template and associated guidelines Review of S75 training programmes and resources.

30 In relation to the advice and services that the Commission offers, what equality and good relations priorities are anticipated over the next (2015-16) reporting period? (please tick any that apply)

x Employment

x Goods, facilities and services

x Legislative changes

x Organisational changes/ new functions

Nothing specific, more of the same

Other (please state):

Employment - finalising Transgender Policy. GFS and Legislation - awaited extension of protection from age discrimination in the sphere of GFS,

Structural - Outcome of the Rafael Bengoa review into Health and Social Care Structures

100

Appendix 1

Accompanying Document to the Trust’s Equality Scheme

Trust’s Equality Scheme S75 Action Based Plan

Period 1st May 2014 – 30th April 2017

This document is available in alternative formats on request. Please contact Lynda Gordon, Head of Equality Assurance Unit, First Floor, Hill Building, St. Luke’s Hospital Site, Loughgall Road, Armagh, BT61 7NQ Telephone: 028 3741 2643/2509/2522 Textphone: 028 3741 2466 E-mail: [email protected]

English: This document can be made available in minority ethnic languages, on request, to meet the needs of those not fluent in English.

Polish: Aby wyjść naprzeciw potrzebom osób, które nie mówią biegle po angielsku, ten Plan Działania może być udostępniony w językach mniejszości etnicznych na życzenie.

Lithuanian: Šis veiksmų Planas pareikalavus gali būti pateiktas tautiniu mažumu kalbomis, kad atitiktų sklandžiai nemokančių anglų kalbos poreikius.

Portuguese: O Plano de Ação está disponível, à pedido, em outras línguas, para atender às necessidades das pessoas que não são fluentes na língua Inglesa.

Tetum: Aksaun Planu ida né,se bele fo ou halo iha liafuan etnika minoria sira nian, nebe bele husu, para bele ajuda ba ema sira nebe la hatene koalia lian Inglés.

Latvian: Šis darbības plāns var būt pieejams mazākumtautību valodās pēc pieprasījuma, lai palīdzētu tiem, kam ir nepietiekamas angļu valodas zināšanas.

Russian: Сейчас план проводимой работы может быть доступен так же на языках этнических меньшинств, по просьбе тех, кто не владеет свободно английским языком.

Czech: 'Aby byly uspokojeny potřeby těch, kteří nemluví plynule anglicky, je možné tento návrh Akčního plánu na požádání poskytnout v jazycích etnických menšin.'

Slovak: Tento Akčný Plán môže byť na požiadanie dostupný v jazykoch národnostných menšín z dôvodu zabezpečenia potrieb tých, ktorí nie sú spôsobilí mu porozumieť v angličtine.

Chinese- (Cantonese):這行動計劃草案將會根據需求被翻譯成各種小數族裔語言去迎合那些英語不流利的人士的需要。

Section 75 Action Based Plan – Appendix 1 – Page (2)

Introduction

The Southern Health and Social Care Trust provides integrated health and social care services to 362,711 people in the Southern Area. The overall purpose of the Southern Trust is to improve health and wellbeing and reduce health inequalities.

The Equality Commission for NI has recommended that all Equality Schemes are accompanied by an Action Based Plan to tackle S75 inequalities and that such Plans should be informed by an inequalities audit.

The Trust’s Action Based Plan (Plan) to promote equality of opportunity and good relations is based on the functions of the Trust and will be implemented through the Framework of the Trust’s Equality Scheme. The measures contained within this Plan are linked to the Trust’s Corporate Planning Cycle in order to ensure that equality of opportunity and good relations are incorporated and mainstreamed at a strategic level into the business of the Trust and aim to address inequalities in health and social care for all of the S75 categories – men, women, persons with and without a disability, persons with or without dependants, persons of different religious belief, political opinion, racial group, age, marital status or sexual orientation. This second plan is for a three year period 2014 to 2017. This Plan is in addition to the commitments set out in the Trust’s Equality Scheme and the Trust’s dual responsibilities to promote equality of opportunity and good relations which are interdependent and complementary to one another.

How the Plan Was Developed

The content of this Plan has been informed by an ‘Audit of Inequalities’ which was undertaken by Health and Social Care Trust Equality Leads in order to identify key inequalities for service users and those affected by Trust policies. As part of the Audit of Inequalities the Trust examined an extensive range of information sources for example complaints received, customer surveys, monitoring information, research documents, annual reports, corporate plans, statistical information and health needs assessments etc. In addition, the Trust pre-consulted with a wide range of service users, service

Section 75 Action Based Plan - Appendix 1 – Page (3)

managers, voluntary groups and organisations, Trade Unions and Equality Commission for Northern Ireland amongst others in order to inform the development of this Plan. Please refer to the Trust’s website (www.southerntrust.hscni.net) for a copy of the Trusts’ recently updated Emerging Themes Document and Consultation Outcome Report which summarises the methods used along with details of those whom we consulted with as we developed this Plan. The Trust has given a commitment in its Action Based Plan to maintain a compendium of literature to ensure its log is relevant and up-to-date to inform on-going and future plans – Action 15 refers.

. Transforming Your Care (TYC) . Southern Health Economy Population Plan 2012/13-2014/15 and Beyond – ‘Changing for a Better Future’ 2013- 15 . Trust Delivery Plan . Developing Better Services – Modernisation of Acute Services . Bamford Review . Change in Mind . Government Strategy - Our Children and Young People . 10-year Strategy for Children and Young People in Northern Ireland 2006-16 . A Strategic Action Plan for Health and Wellbeing Changing Times for Older People – Living Life to the Full . Priorities for Action . Public Health Agency Annual Commissioning Priorities . Public and Personal Involvement (PPI) Strategy and Trust Directorate Plans . Southern Trust’s Race Equality in Health Action Plan . Trust Health Improvement Plans . Trust Community Development Action Plans . SHSCT Traveller Action Plan . SHSCT Carers Action Plans . SHSCT Disability Action Plan . CAWT Initiatives aimed at tackling health inequalities . Thematic Regional Work streams e.g. Regional Ethnic Minority HSC Wellbeing Steering Group

(This list is not exhaustive).

Section 75 Action Based Plan - Appendix 1 – Page (4)

Structure of the Plan

The Plan includes a number of action measures which are short-term (1 year), mid-term (2-3 years) and long-term (3+ years), some of which may roll over into subsequent plans. These measures are aimed at reducing inequalities in health and social care. The Plan is structured as follows:

SECTION THEME PAGE NO.

Section 1 ‘Cross Cutting Themes’ is framed around 5 recurrent themes from the audit of inequalities as follows:

. Theme 1: Measures to Improve Access to Services, Communication and 10-22 Information – 6 specific action measures (1 thru 6) . Theme 2: Service Monitoring – 3 specific action measures (7 thru 9) 23-26 . Theme 3: Measures to Ensure Mainstreaming Equality, Good Relations, 27-34 Disability Duties and Human Rights Considerations into the Corporate Planning Cycle and Decision Making Processes – 7 specific action measures (10 thru 16) . Theme 4: Measures to Promote Participation and Inclusion – 3 specific action 35-51 measures (17 thru 19)

. Theme 5: Procurement – 1 specific action measure (20) 52-53 .

Section 2 Service Related Issues – 14 specific action measures (21 thru 34) 55-84 Section 3 Employment Related Issues – 12 specific action measure (35 thru 46) 88-112

NB: For ease of navigation a quick reference matrix has been added to page 8 of this Plan which links each action measure with the S75 group(s). As a result of feedback received during consultation we have indicated which actions are new to the plan or are on-going from the previous plan and which are regional or local. Section 75 Action Based Plan - Appendix 1 – Page (5)

The Way Forward

Whilst the primary purpose of conducting the audit was to inform this plan, the information from the audit will also be used to develop future policies, as well as shape and inform the design and delivery of services, including informing equality screening and equality impact assessments. (Please refer to the Glossary Appendix 5 of the Equality Scheme for definitions).

In identifying the measures in this Plan the Trust has also considered what monitoring information it needs to collect in order to evaluate whether the outcomes have been achieved.

Formal Consultation – A Sectoral Approach

As well as pre consulting with key stakeholders such as the Equality Commission for NI, HSC Trusts formally consulted on their draft Action Based Plan over a 12 week period commencing 26th March 2014 and ending 19th June 2014. In addition a stakeholder event was hosted on 26th March 2014 to which the ECNI and the voluntary and community sector were invited to mark the commencement of the 12 week consultative process. Comments received were very much welcomed as were suggestions regarding further action measures. All comments received have helped to inform and shape this second Action Based Plan.

A copy of the Consultation Outcome Report is available on the Trust’s website.

Action Measures

This Plan includes measures which the Trust initiates, sponsors, participates in, encourages or facilitates. It also includes regional and local measures which the Trust will work in partnership with other Health and Social Care organisations, voluntary and community sector, trade unions etc. to achieve. The Trust has chosen measures and prioritised those that have the greatest impact on equality of opportunity and good relations. Priorities in this plan have been informed by the HSC Trusts Regional Pre Consultation Event held in March 2014, views and input from the disability sector arising from a 12 week formal consultation event, HSC Trusts Emerging Themes Inequalities Audit as Section 75 Action Based Plan - Appendix 1 – Page (6)

well as pre-existing work streams currently being rolled out in the Trust to tackle inequalities within HSC. This Plan is designed to be flexible, adaptable and responsive to changing circumstances and needs and will be reviewed on an on-going basis and annually via the Trust’s Equality Scheme. Progress against the Trust’s previous Section 75 Equality Scheme Action Based Plan is documented in the Annual S75 Progress Reports to the ECNI which are available on the Trust’s website.

The Action Plan provides a framework for action which sets out the key actions that will be taken forward over the period 2014 – 2017. It identifies a number of actions that draw on best practice in an era of economic pressure. Many of the actions are not resource dependent but are intended to ensure that the promotion of equality of opportunity and good relations in existing programmes of work. Over the course of implementation there may be a requirement to develop more detailed actions to ensure that the Plan remains outcome focused and measurable.

All enquiries should be made to:

Contact Details

Mrs Lynda Gordon, Head of Equality Assurance Unit Southern Health and Social Care Trust First Floor, Hill Building, St. Luke’s Hospital Site, Loughgall Road, Armagh, BT61 7NQ Tel: 028 3741 2643/2509/2522, Textphone: 028 3741 2446 E-mail: [email protected]

Section 75 Action Based Plan - Appendix 1 – Page (7)

ACTION BASED PLAN - QUICK REFERENCE GUIDE

Section 75 Page Page Page Action Status Section 75 Group Action Status Section 75 Group Action Status Group No. No. No. Race 1 C 10 Race/Religion 22 C 57 Gender 43 R 107

Disability 2 C 14 Age/Gender 23 R 58 Gender 44 R 109 Gender/Marital Race 3 C 17 Race/Dependants 24 C 61 45 C 110 Status/Dependants Religion 4 C 18 Race/Dependants 25 C 62 Age 46 R 111

Race/Disability 5 C 20 All S75 Groups 26 C 64 Age/Disability/Race/ Race 6 C 21 27 C 66 Dependants Race 7 C 23 Age 28 C 67

Race 8 C 24 Race 29 C 72

Disability 9 C 25 Race 30 C 75

All S75 Groups 10 C 27 Race/Disability 31 C 77 Gender/Sexual All S75 Groups 11 C 28 32 C 80 Orientation All S75 Groups 12 R 30 Age/Disability 33 C 81

All S75 Groups 13 C 30 Age/Disability 34 C 82

All S75 Groups 14 C 31 Gender 35 C 88 Race/Political All S75 Groups 15 C 33 36 C 90 Opinion/Religion Gender/Sexual All S75 Groups 16 C 34 37 C 92 Orientation All S75 Groups 17 C 35 Disability 38 C 94

All S75 Groups 18 C 36 Gender/Race 39 C 100

All S75 Groups 19 C 49 Religion 40 C 103

All S75 Groups 20 C 52 Age 41 C 105 Race 21 C 55 All S75 Groups 42 R 106

Status: C completed R denotes action that have been Rolled over to the 2017-2022 Action Based Plan

Section 75 Action Based Plan – Appendix 1 – Page (8)

SECTION 1

CROSS CUTTING THEMES

Theme 1: Measures to Improve Access to Services, Communication and Information – pages 10-22

Theme 2: Service Monitoring – pages 23-26

Theme 3: Measures to Ensure Mainstreaming of the Equality, Good Relations, Disability Duties and Human Rights Considerations into the Corporate Planning Cycle and Decision Making Processes – pages 27-34

Theme 4: Measures to Promote Participation and Inclusion – pages 35- 51

Theme 5: Procurement measures – pages 52-53

Section 75 Action Based Plan – Appendix 1 – Page (9)

Section 1 – Cross Cutting Themes Theme 1 – Improving Access to Services, Communication and Information

Recurring Theme Inequalities Audit – Language and communication difficulties present as major barriers in accessing Health and Social Care for some S75 Groups

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Action 1: Regional Interpreting support Regional Increase in the number of Year 1 HSCB Ongoing Action Oversight people who access To support the Steering Group interpreting support Action Plan that will Northern Ireland . Review of implementation of the established. including those who do be subject to on- Health and Social guidance and findings of the review not speak English as a going monitoring. Care Interpreting policies on of interpreting support Action plan first language, for Service (NIHSCIS) provision of for health and social developed. example, BME interpreting care appointments Communities and Equality Leads/HSC support. commissioned by the Regional Strategy Migrant Workers and organisations . Ensure equality Health and Social Care developed. those who speak Irish as of opportunity for Board (HSCB). a first language. BME people in Sustainable, fit accessing health Support will be for purpose Increase use of and social care provided through model of telephone interpreting services. participation in a interpreting to where appropriate to . Reduce language regional oversight help facilitate make best use of and steering group language support available resources. communication established to ensure for increasing Trusts will have a barriers. the review findings are linguistic diversity consistent approach to taken forward. in HSCNI. interpreting and Sources: The Health of translation Service model BME, King’s Fund, To run “working well Programme of that will deliver future London with interpreters” awareness raising to Section 75 Action Based Plan - Appendix 2 – Page (10)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) NICEM training across all promote interpreting services. Trusts. guidance. Ethnicity, Equality and Human Rights: Access To promote awareness Service Level to H&SS in NI of the Code of Agreement for

Courtesy for the Irish future New to Northern Ireland Language through interpreting – A study of the issues service. faced by migrant, above Working Well with Interpreters asylum seeking and Extension to the sessions, via refugee children in regional register associated Northern Ireland of interpreters to Professional Codes for meet demand for European Charter for Interpreters and HSC minority Regional or Minority Practitioners - to languages Languages include guidance on the Code of Courtesy Review of Interpreting Arrangements for the Irish Language. Support for Health and are in place for Social Care telephone and Appointments (HSCB) face to face 2013 interpreting for the Irish

Language as well as for written translations. Action 1 – Notes of Attainment: Action Completed

The Northern Ireland Health & Social Care Interpreting Service (NIHSCIS) was established in 2004 and was originally managed by the legacy Eastern Health & Social Services Board. In 2007, Legacy Trusts were asked to express an interest in taking on management and running of the Service. SEBT obtained responsibility for the Interpreting Service and in 2008 this was subsumed by the Belfast Health & Social Care Trust (BHSCT).

Section 75 Action Based Plan - Appendix 2 – Page (11)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) A review was commissioned by the Health & Social Care Board (HSCB) in 2011 - largely due to the growth in demand for interpreting. Additionally, there was a need for increased accountability mechanisms and a decision on the best strategic fit in going forward.

A comprehensive review was conducted by the HSC Leadership Centre and was issued for full public consultation. The Southern Trust's Race Equality Forum provided a detailed and informed response to this public consultation. Notably, the SHSCT remains the biggest user of this service routinely drawing down 50% usage rate - as evidenced in the management information provided to HSC Trusts - see number of requests per Trust below.

Amongst the recommendations for change was a re-profiling of interpreting usage by increasing the ratio of telephone interpreting to face to face interpreting. Previously there had been a disincentive to use telephone interpreting as HSC Trusts were not able to recover the costs from the HSCB - unlike face to face interpreting where costs are recouped by Trusts. In order to encourage increased uptake of telephone interpreting the HSCB agreed to cover costs for both services.

Another key recommendation was the transfer of management responsibility from BHSCT to the Business Services Organisation (BSO) in line with strategic direction of travel for regional services that are deemed transactional in nature. This transfer took place on 1st October 2014 as it was seen a better strategic fit.

A Project Group chaired by the HSCB's Director of Commission oversaw the transfer of this service to the BSO. Further, the review acknowledged that there was a need to invest and overhaul the database that was no longer fit for purpose particularly in view of the significant increase in demand for this service.

Work has progressed in terms of the production of a consistent set of regional guidelines and the development of an IT web-based portal for booking interpreters and for their acceptance or rejection of assignments. Notably, this new system will comprise an interface with Finance which will significantly reduce the volume of paper invoices produced for some 95,000+ interpreting interactions. In moving forward, HSC practitioners will be required to log onto the system and will be prompted to answer a series questions (against stipulated criteria) to discern if their interaction warrants a face-to-face or telephone interpreter. Depending on the duration, nature and complexity of the appointment, the appropriate interpreting source can be selected. Interpreters will use a barcode to scan in each practice to verify the duration of the appointment.

Work has also been ongoing with The Big Word, the sole telephone interpreting provider, to ensure that they are geared up to cater for the anticipated increase in demand once the new IT system went live in Autumn 2015. Section 75 Action Based Plan - Appendix 2 – Page (12)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) A Regional Advisory Group has recently been established to inform the strategic direction of the service. HSC Trust Equality Leads were invited to participate in the group and it was agreed that Equality Managers from Belfast and Southern Trust would represent all the Trusts with the SHSCT being the biggest consumer of this service. It is anticipated that service users will also be invited to participate in a regional service user panel - representatives from the Trust's Race Equality Forum have already expressed their interest.

2015/16 Update:

The new web-based IT Portal was successfully deployed to all HSC organisations during the year under-review. HSC Equality Leads worked with the NI Interpreting Service staff to ensure a seamless transition and to ensure that there were no interuptions to service provision. Training has been ongoing throughout the deployment phase to ensure that users were in a state of readiness to go online. Communications were placed on each Trust’s intranet and notices issued via global.

The project group found that stakeholder engagement was crucial to the successful development of the new IT Portal in that all the stakeholders were able to inform the development of same and the software. Training and engagement began in June 2015 and implementation took place in January 2016. System user guides were created and circulated across the Trusts and Primary Care.

The introduction of the system has led to a number of cost savings and has the potential to realise further reduction in spend:

Redeployment of finance staff (equating to £81,355 per year):  Paperless office in NIHSCIS, paperless process for interpreters, paperless process for Finance  Reduction in the risk of fraudulent claims  Reduction in the double bookings and cancellation costs  Potential to reduce long term use of agency staff.

The most popular languages vary across the geographical spread but the top languages of the region are shown below:

Polish 8142, Lithuanian 4308, Romanian 2363, Portuguese 2263, Chinese – Mandarin 1388, Slovak 1211, Tetum 1209, Hungarian 942, Bulgarian 861, Chinese – Cantonese 748, Arabic 713, Russian 695, Latvian 571, Somali 273, Czech 245, Spanish 155, Chinese – Hakka 153 Farsi 112, Bengali 87, Italian 75.

Work will be ongoing to shift the balance of face to face interpreting to more appropriate usage of telephone interpreting for those appointments Section 75 Action Based Plan - Appendix 2 – Page (13)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) which are less complex and more straightforward. The Regional Steering Group has been officially stood down having completed out on the implementation of all the recommendations from the review and a new oversight/regional advisory group has been established in its place.

The total number of SHSCT requests for face to face interpreting for the period 1st April 2015 – 31st March 2016 was 46,476. The top main languages in the SHSCT are as follows: Polish, Lithuanian, Portuguese, Tetum, Bulgarian, Romanian, Russian, Latvian and Slovak. The SHSCT remains the biggest user of the NIHSCIS reflecting the demography of the local area. Action 2: Regional Physical and Sensory Framework Improved understanding of Year 2 HSCB Ongoing Action Disability Strategy established which future demand for sets out the key Services by mapping Project subject to on- Equality Leads/HSC . Support disabled To continue participation actions that will be existing services to going monitoring. organisations including people to better on the Regional Physical taken forward until establish potential gaps in Specialist Services exercise their Sensory and Disability 2015. addressing need. The Disability Team within Trusts. rights. Strategy Implementation Strategy . Support the Group to direct, Project action and Improved provision of high- Implementation Group continuing coordinate and manage implementation quality advice and is accountable to the development of an the project infrastructure plan that includes information to HSC, DHSSPS for inclusive and and implementation of actions to promote voluntary and community implementation of the effective range of the Physical and Sensory positive health, sectors to ensure effective Strategy. The Group high quality health Disability Strategy and wellbeing and early decisions regarding the ensures summary and social care Action Plan. intervention and future planning, progress reports services. actions to provide commissioning, delivery within each . Develop a more better services to and monitoring of services. Trust area is provided support to the HSC Board on integrated approach to the independent lives. Improved collaboration a six-monthly basis. between Trusts and local planning and management of Fully accessible providers when designing The measures of

services. communication and new service models. outcome and Source: Access to training improvement Public Services for Deaf materials, Improved sharing of achieved are Sign Language Users (including where emerging service-based assessed against Key (Action on Hearing Loss appropriate web- learning and good practice Performance (RNID) and BDA) based material) across NI. Indicators. both for those Section 75 Action Based Plan - Appendix 2 – Page (14)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Physical and Sensory using services and Disability Strategy for health service and Action Plan 2012– professionals and 2015 practitioners. Action 2 – Notes of Attainment: Action Completed

Taking action to address inequalities and identify gaps in service provision is the overall rationale for the Physical & Sensory Disability Strategy 3 Year Action Plan which is now entering its final phase. The Strategy Implementation Group leading the work is cross Departmental and includes HSC Board, PHA, Trusts, DEL, DSD, voluntary organisations and service users. Actions taken forward to date include the following:

2015/16 Update:

The following list represents some of the P&SD funded initiatives:  Wheelchair services funding  Deafblind initiative  Regional Review of Communication Support Services  Community Access and Social Networking initiatives.

A Good Practice Guidance Checklist has been drafted to ensure the needs of people with disabilities are considered in the design and development of health promotion programmes campaigns.

A Developing Eyecare Partnership (DEP) Regional Group has been established under the leadership of Dr J McCall (PHA) and R Curran (HSCB).

A Task & Finish Group including HSCB, PHA and Action on Hearing Loss (AoHL) was set up to identify and promote preventative messages in relation to hearing loss.

“My Journey My Voice”, a powerful interactive multimedia exhibition which highlights living with a communication disability from a service user’s perspective was launched on 2 November 2015 as a partnership initiative between health and social care and Disability Action. A regional deafblind needs analysis report was completed and key findings of this review were launched at a workshop in autumn 2015.

Section 75 Action Based Plan - Appendix 2 – Page (15)

The 5 Trusts have adopted a phased approach to the implementation of SDS. It is planned that by end March 2019 SDS will be mainstreamed across all programmes of care within each Trust. SDS NI development takes cognisance of the learning from across the UK and contacts are maintained with some Local Authorities in England. In addition the SDS initiative has undertaken a full Equality Impact assessment with the consultation concluding in May 2015. The SDS initiative introduces a co-production approach with service users and carers as equal partners in developing their support plans following assessment of need. This approach by nature is person-centred and training is currently being rolled out across the 5 Trusts over 3 levels with level 3 covering assessment and individual support planning.

The Accessible Formats policy and guidance has been issued to HSC organisations through the Regional Accessible Formats Steering Group.

Work has commenced with the Business Services Organisation Procurement and Logistics Service to explore developing a regional contract for the provision of accessible formats services (such as Braille or audio formats).

Making Communication Accessible for All - A Guide for HSC staff has been developed and will be made available in early 2016.

A Level 1 E-Learning Sensory awareness raising programme for hearing and sight loss was piloted with Trust staff over the summer/autumn period of 2014. The feedback from this pilot will be used to refresh and update the training tool prior to launch in 2016.

Version 4 of NISAT (Northern Ireland Single Assessment Tool) incorporates a Carer’s Support Tool, this is due to be approved by DHSSPS in early 2016. The significant change in this version is the greater requirement for support planning as part of the assessment stage. In addition, the information gathering in the assessment is designed to identify carers at risk.

The volunteer buddy service was introduced within Disability Action (DA) in February 2014. The aim of the service is to assist people who want to learn to travel independently using public and community transport. Information regarding the service has been placed in community magazines and leaflets were distributed throughout the service users within DA’s employment support services and placed on their website. The main aim of advertising this service has been to interest people wanting to be travel buddies and users who want to use the service.

Section 75 Action Based Plan - Appendix 2 – Page (16)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Action 3: Regional Health and Social Booklet reviewed Improved awareness of Year 1 Equality Leads/HSC Ongoing Action Care Booklet and launched. health and social care organisations structure and services Monitored through . Increase staff To review and launch Resource for among people from Annual S75 awareness of updated Health and people moving minority ethnic Progress Report to cultural needs to Social Care Booklet to into Northern backgrounds who have Equality eliminate provide information Ireland. moved to NI. Commission. barriers. about health and social . Ensure equality care to people from Improved access to of opportunity for minority ethnic services. BME people backgrounds who have accessing moved to Northern More timely intervention services. Ireland. and ultimately better . Need for clear up health outcomes. to date information for BME people.

Source: New to Northern Ireland - A study of the issues faced by migrant, asylum seeking and refugee children in Northern Ireland, 2010

OFMDFM Race Strategy 2005-2010 Action 3 – Notes of Attainment: Action Completed

The booklet has been subject to review by the Health and Social Care family. Progress was delayed due to legislative reform in terms of the Provision of Health Services to Persons Not Ordinarily Resident Regulations (Northern Ireland) 2015. HSC Trust Equality Leads responded to the consultation on this legislation along with many other organisations such as the Law Centre NI who wished to see an extension of the Section 75 Action Based Plan - Appendix 2 – Page (17)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) previous entitlement to allow asylum seekers free access to health care. The most recent version of this booklet has been issued for comment to HSC Trust Equality Leads and to the Health and Social Care Board and DHSSPSNI Equality Leads. The booklet was also been shared with the Counter Fraud Unit in the Business Services Organisation for quality assurance.

This booklet is intended to help new arrivals to NI and those unfamiliar with the NIHSC system with way-finding. Amongst other things it explains the role of interpreters; how to register with a GP; the Out of Hours Service along with a range of other hospital based and community based services. How to make a complaint is also explained. There are links to other useful information such as the Choose Well Campaign – which is about signposting to the appropriate service.

2015/16 update:

This revised booklet was launched during the current reporting period 2015/16 to coincide with the arrival of the first groups of Syrians. The booklet was translated into the top main ethnic minority languages (Farsi, Russian, Arabic, Portuguese, Bulgarian, Latvian, Romanian, Lithuanian, Somalian, Polish) and further translations were requested to reflect the diversity of language needs in NI. The cost of these translations was spread across all HSC organisations.

The booklet was heralded as timely and very informative by practitioners who have been working with Syrians and different newly arrived migrants. Action 4: New Spiritual Care Policy Policy on how Increased awareness Year 1 Executive Council of Regional Action spiritual care among health and social the NI Healthcare To develop a Spiritual services are care staff of spiritual Monitored through Chaplains’ . Increase staff Care Policy based on recognised and needs. Annual S75 Association awareness that the template provided provided within Progress Report to different cultural, by the Northern Ireland hospital and Improved holistic care for Equality Local Chaplains faith and belief Healthcare Chaplaincy community patients. Commission. groups have a Service. services. Trust Equality Leads variety of views Improved on health, ill- multidisciplinary working health, birth, among health and social dying and death. care professionals. . Total care

Section 75 Action Based Plan - Appendix 2 – Page (18)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) includes care for the physical, social, psychological and spiritual dimensions of the person. Source : Code of Conduct for HPSS Healthcare Chaplains (UKBHC 2010) (DHSSPSNI (2011)

Meeting the Religious and Spiritual Needs of Patients and Staff (DHSSPSNI 2004) Action 4 – Notes of Attainment: Action Completed

Meetings took place during the year under review with the Trust’s Quality and Patient Support Officer, the Trust’s Records Management Officer and the Trust’s Equality Manager to discuss this draft Policy which is premised on the NI Healthcare Chaplains Association template and intended for adoption by all HSC Trusts. The main topics of discussion were issues surrounding confidentiality of patients’ records and Data Protection/Management. A number of actions emanated from these meetings and included a presentation of the draft policy to the Trust’s Chaplaincy Forum in February 2015 to obtain their views on the draft policy and to secure their buy in. Records Management & Data Protection training was provided to the Chaplaincy Forum to address any concerns and to provide clarity around records management. The latest draft policy along with the equality screening template were shared with both the Trust’s Chaplaincy Forum and tabled at the Trust’s Race Equality Forum in February 2015 for further discussion. One of the Hospital Chaplains also attended the Race Forum meeting which resulted in a few minor adjustments to the draft policy.

2015/16 update: The draft policy and associated screening template were finalised during the year under review.

Section 75 Action Based Plan - Appendix 2 – Page (19)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Action 5: New Cultural Competence Draft online Increased awareness Year 1 Belfast Trust in Regional Action in Mental Health toolkit - among mental health conjunction with HSC Services developed in practitioners of potential Monitored through Trusts and Aware . Access to mental partnership with barriers and challenges Annual S75 Defeat Depression. health services To develop an online mental health for minority ethnic Progress Report to for minority ethnic toolkit to offer practical service users and communities accessing Equality communities. advice and good representative services. Commission and . Important to practice information for organisations. project steering consider issues mental health Improved access to group. relating to practitioners on Toolkit piloted mental health service for ethnicity and optimising their cultural with mental increasingly culturally culture - Mental competence. health diverse population. Health and Ethnic practitioners minorities in To develop a DVD and across the region. Better health outcomes in mental health associated training mental health for BME services. materials on cultural Online toolkit service users. competence in Mental formally launched Source: University of Health Services. as regional Increased confidence Birmingham & Northern resource on PHA among BME service Birmingham Mental website. users to access and use Health Trust mental health services. February, 1995

Research in 2013 conducted by Rooney for Ballymena Inter- ethnic Forum Action 5 – Notes of Attainment: Action Completed

Northern Ireland now is home to a much greater breadth of cultural diversity - the Census 2011 identified that 1.8 per cent (32,400) of the resident population of Northern Ireland belonged to Black and Minority Ethnic (BME) Groups, more than double the proportion in the 2001

Section 75 Action Based Plan - Appendix 2 – Page (20)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Census. Research in 2013 found that there was a low uptake of mental health services by BME communities. Delivering mental health services can be complex, but this becomes even more difficult when cultural and linguistic differences exist. In 2013 the Public Health Agency (PHA) provided funding on a regional basis specifically to examine how HSC mental health providers could be supported in the delivery of culturally competent services. Aware Defeat Depression worked in partnership with Health and Social Care Trust representatives to look at how best to support this initiative. This partnership convened a regional conference in June 2013 for mental health specialists across the statutory, community and voluntary sectors. The focus of this event was “Developing Cultural Competence when delivering Mental Health Services to Black and Minority Ethnic Communities”, which looked at the complexities of delivering mental health services in this context. There was general agreement that mental health professionals would welcome the development of an online toolkit for specific advice or good practice in this area.

An Ethnic Minorities Mental Health Toolkit which essentially is a guide for Practitioners was developed as a result of the regional conference and feedback. It is available online at the PHA website and a number of hard copies have been provided to each Trust. The toolkit is broken down into quick reference sections with hyperlinks to more detailed reports or useful resources and there are a number of appendices with useful links. http://www.belfasttrust.hscni.net/pdf/BME_Cultural_Awareness_Document_sml.pdf. The SHSCT responded with details of local contacts and initiatives to be included in the final Toolkit. Nuala Quinn, SHSCT, Mental Health Directorate participated in the roll out of training – T4T.

2015/16 update:

The final version of the Mental Health Toolkit – A Guide for Practitioners - has been uploaded to the Trust’s intranet and promoted in the Trust’s ‘Southern-i’ (corporate magazine). It has also been highlighted in Primary Care settings via the GP intranet and in Practice Talk. An accompanying DVD and Train the Trainer session has helped improve usage and awareness of the resource and the concept of cultural competency. Action 6: Partnership working Engagement Improved Networking Year 1 and on-going HSC Equality Leads Ongoing Regional with BME process with key groups. and Trust PPI Leads. Action Communities established with Annual monitoring representative Enhanced health and via ECNI Progress . Need for To further promote individuals and social care services to Report. enhanced partnership working organisations. BME service users. networking with BME organisations Monitoring of structures with such as Stronger Trust Steering Group BME Together to help membership of Action Plan. communities. identify and address local and regional Section 75 Action Based Plan - Appendix 2 – Page (21)

Key Inequalities Performance Indicator Timescale & Identified and Source Description of Action Measure Lead Person Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Source : Regional health and social care networks. Minority Ethnic Health issues affecting BME and Social Wellbeing communities. Regional Funding Steering Group of Network. Action 6 – Notes of Attainment: Action Completed

2015/16 update:

The Regional Minority Ethnic Health and Social Wellbeing Network continue to support the Stronger Together Network. During the reporting year, one BME Health and Social Wellbeing initiative was held in each of the 5 Trust areas. Local engagement sessions included workshops on No Recourse to Public Funds and Domestic Abuse. The database for local BME Groups was also updated. The NI New Entrance Service (NINES) Project has been established in both the Belfast, Southern and Western Health and Social Care Trust areas during 2015/16. In addition to this an application for funding has been made to support a Regional BME Carers Research Project. Trust staff have also been engaged in working with the new Councils in the development of an assessment of need and profiling of BME communities.

The Trust’s Race Equality Forum continued to meet during the current reporting period. Its membership was extended to include the Head of Early Years and Parenting – SHSCT. The Forum also produced a Progress Report of key activities against its agreed action plan – a copy of which can be obtained by contacting Mrs Lynda Gordon (see page 7 of this document for contact details).

The HSC Trust Equality Leads also attended an event hosted by ‘Stronger Together’ at Belfast Castle during 2015/16 entitled ‘Achieving Racial Equality– A Shared Responsibility’. A welcome was extended by William Olphert, from the Chinese Welfare Association and inputs were provided by Don Flynn, Migrant Rights Network and Bernadette McAliskey who provided insight to the BME Mental Health Pilot which is funded by the PHA.

The breakout sessions included mainstreaming cohesion in community planning, racial equality strategy – making it known and creatively enabling its successful implementation, employment and employability as well as an overview of racial equality in health – key successes. The resultant outcome from the racial equality workshop in health was a list of issues for consideration in framing HSC Trust Equality Schemes – Action Based Plans for 2017-2020/22.

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Section 1 – Cross Cutting Themes Theme 2 – Service Monitoring

Recurring Theme Inequalities Audit – Absence of an effective monitoring system makes it difficult to plan and respond to the changing need profiles of the population and model services accordingly

Performance Indicator Timescale & Key Inequalities Description of Action Measure Lead Person Identified and Source Monitoring Outcome/Impact (For Output Arrangements S75 Groups) Action 7: Ethnic Monitoring Data on BME service Improved data on BME Year 1 DHSSPS, HSCB, Ongoing Regional users accessing communities accessing HSC Trusts. Action - To continue to roll services. Trust services. Monitoring of ethnic out ethnic monitoring returns. . A need to monitoring to key Potential gaps in data Improved monitoring of improve ethnic information identified. service provision. monitoring of systems such as services. CHIS, NIMATS and Guide on Ethnic PAS. Monitoring of Service Source : NICEM Users in HSC (NI) Seminar Report, Ethnic launched - September Monitoring in NI (2010) 2014.

Race Equality in Health and Social Care, A Good Practice Guide. ECNI (2011)

Racial Equality Policy Draft Priorities and Recommendations ECNI (2013)

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Ethnic Monitoring of Service Users is in place in a number of key information systems – Child Health System, PAS, SOSCARE, SureStart and NIMATS. An audit of progress on implementation on each of these systems was planned for July / August 2015. The Ethnic Monitoring leaflet for Service Users has been translated into the top five languages for use across all HSC Trusts. This has been circulated throughout the five Trusts. Information for staff in the form of Key Tips for Staff has also been circulated and is available on the Trusts’ intranet sites. This information has also been included in information packs for a Regional Midwifery Conference (23-1-15). Specific training has also been provided to other groups of staff e.g. through the Social Work Forum. The Regional Ethnic Monitoring Guidance has been finalised and the Regional Ethnic Monitoring Group are in discussions with the HSCB in relation to the release and roll out of this Guidance.

2015/16 Update:

The Guide to Ethnic Monitoring of Services Users in HSC in NI along with supporting materials has now been issued by the Chief Executive of the HSCB to all HSC Organisations in March 2016 for implementation where ethnic monitoring data is currently being collected or planned to be introduced on information systems. The use of this new Guide will help HSC commissioners/providers to robustly capture critical patient/service user information on existing and emerging BME communities using HSC services. Most importantly, it will help HSC organisations to identify any unmet need and to target their resources accordingly thus tackling health inequalities experienced by BME communities. The availability of the Guide and supporting monitoring materials was further circulated by HSC Trusts under covering letter to those staff with data collection responsibilities, those responsible for developing new IT monitoring systems and those directly interfacing with service users, patients and clients e.g. clinical and nursing staff, etc. The Ethnic Monitoring Project in HSC has been positively referenced by the OFMDFM Race Equality Unit. Ethnic Monitoring of staff continues to be collated by the Trusts and this has been enhanced by HRPTS Self-Service functions. Action 8: New Local Monitoring - Implement and roll out Trust able to plan and 2014 - 17 Community Action Traveller uptake new Community respond to the changing Information System Information System. need profiles of the Team, SHSCT . Absence of an Develop population and model effective mechanisms to services accordingly. monitoring monitor and system makes it evaluate the uptake difficult to plan of services by and respond to Travellers and

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Performance Indicator Timescale & Key Inequalities Description of Action Measure Lead Person Identified and Source Monitoring Outcome/Impact (For Output Arrangements S75 Groups) the changing other BME need profiles of communities. the population and model services accordingly. Action 8 – Notes of Attainment: Action Completed

The PARIS community information system (CIS) is currently being deployed and has a long term implementation plan. Using a phased approach PARIS is being rolled out across the Southern Trust and will provide a single integrated community based service electronic record. PARIS has the ability to capture ethnicity. Teams who have CIS installed are being targeted. To date, a number of services have been implemented and plans are in place for further deployment. All staff using the system are provided with training on use of the system and the importance of data quality. Data quality and system usage is also monitored at monthly project board meetings. Ethnic Monitoring poster, leaflet and guidance developed regionally are now available on the Trust’s intranet. Slides on ethnic monitoring and the resources to support managers with the introduction of same have been included in staff training on ‘Data Quality’.

2015/16 Update:

The interface from the PARIS Community Information System to the Northern Ireland Electronic Care Record (NIECR) is now live for the Southern Trust. This interface collects certain information from the PARIS application on a daily basis and displays it in 2 areas on the NIECR ‘Community Services’ window-let within the’ Patient Summary’ tab and ‘Community Services’ tab. PARIS has the ability to record ethnicity for all clients. Reports are available on the system to monitor ethnicity. Approval to extend the project by another 3 years has been granted so roll-out will continue until March 2019. As mentioned above ethnic monitoring resources have been provided to staff to facilitate the collection of ethnic monitoring data. The Ethnic Monitoring Guidelines – launched in March 2016 - have been uploaded to the intranet for staff use. Action 9: Complaints DVD Resource available for Increased awareness Year 1 and on-going HSC Trust Equality Ongoing Regional the Deaf and Hard of among the deaf Lead Action - Hearing Community. community of the Monitoring of the Promotion of Resource available on complaints procedure number of complaints Complaints/Patients . Low number of Regional HSC Trusts websites. and how to access the received. Liaison Manager

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Performance Indicator Timescale & Key Inequalities Description of Action Measure Lead Person Identified and Source Monitoring Outcome/Impact (For Output Arrangements S75 Groups) complaints Complaints DVD: Promotion of availability procedure. received from ‘Complaints of DVD through training deaf and hard of Procedure: A guide and awareness events. Improved access for the Reporting through RNID hearing on How to Alternate formats deaf community to the S75 Annual Progress community. Complain’. available for the complaints procedure. report. submissions of, and Source: Action on response to, complaints Hearing Loss 2013 Evaluation of the Service user effectiveness of the feedback. DVD. Action 9 – Notes of Attainment: Action Completed

2015/16 update:

A DVD has been produced and promoted regionally. The DVD is now available on all Trust websites. NB: there has been no notable increase in volume of complaints from service users who have gained a better understanding of the complaints process through the DVD. Also no quantifiable increase in number of complaints from the deaf and hard of hearing community who have learnt about complaints process through the DVD. Various ways have been discussed with regard to capturing information e.g. anecdotal, BDA, Survey Monkey.

South Eastern Trust Complaints/Patient Liaison Manager is working with colleagues from other HSC Trusts to identify any potential regional increase of complaints from this community. Also, further feedback is to be gathered from Survey Monkey with regard to finding data on how patients discovered how to make a complaint e.g. through the website.

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Section 1 – Cross Cutting Themes Theme 3 – Mainstreaming Equality, Good Relations, Disability Duties and Human Rights Considerations into the Corporate Planning Cycle and Decision Making Processes

Recurring Theme Inequalities Audit – Absence of mainstreaming makes it difficult to ensure an equality perspective is incorporated in all policies at all levels and at all stage by those normally involved in policy

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 10: Annual Progress Annual Progress Increased awareness Year 1 HSC Trust Equality New Regional Report Report available in among stakeholders of Leads in conjunction Action accessible user the equality work taken Monitored through with ECNI To work with the friendly format. forward by Health and Annual S75 Progress . User friendly ECNI to develop a Social Care Trusts. Report to Equality version of user friendly and Commission. Annual accessible Annual Progress Progress Report. Report will be accessed by wider audience.

Source: Review of Equality Scheme (ECNI) Action 10 – Notes of Attainment: Action Completed

Previously an ECNI led event was held on 11th March 2015 where a presentation on the new template was provided by Lisa King (ECNI). A follow up meeting took place on 21st April 2015 with the ECNI and HSC Trust Equality Leads to discuss in more detail the new template and expectations

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) in going forward with the completion of same. The new template is now in use to record progress for the current reporting year 2014/15 and here on in. HSC Trust Equality Leads have fed into the consultative process led by the ECNI.

2015/16 Update:

HSC Trust Equality Leads have incorporated feedback from the Equality Commission for NI from the submission of their 2014/15 S75 Annual Progress Reports into their reports for the current period 2015/16. Action 11: Screening Template Easy to follow All Trust policy makers Year 1 HSC Trust Equality New Regional screening template will use easy to follow Leads in conjunction Action To review the HSC and guidance that screening template and Monitored through with ECNI . Current Trust screening meets the needs of guidance. feedback from staff template not template and health and social using template and reflective of associated guidance. care. Increased satisfaction guidance and Annual the clinical among policy leads and S75 Progress Report to policy areas. All Trust policy decision makers when Equality Commission. makers will use using template and Source: Review of easy to follow guidance. Equality Scheme screening template (ECNI) and guidance. Action 11 – Notes of Attainment: Action Completed

A review of the current equality screening template was undertaken in 2014/15 and has been piloted by 2 HSC Trusts i.e. the Belfast Trust and the Northern Trust. Discussions about the screening template have been ongoing for some time between all HSC Trust Equality Leads and the Equality Commission for NI. Much of the discussion has centered on the length of the screening form and its application where policies are clearly technical or clinical in nature and have no bearing on equality of opportunity or good relations. Essentially, this is what prompted a review of the screening template which, under the pilot, allows for HSC managers to screen out policies that are technical or clinical in nature at an early stage - subject to adhering to a number of stipulations laid down by the Equality Commission to ensure continued compliance with the S75 Statutory Guidelines.

The Trusts having notified consultees of their intended pilot in advance and, having drawn their attention to the quarterly screening outcome reports

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) in the interest of transparency, have decided to extend the pilot for another 3 months to further scope the user friendliness and identify any further improvements in policy assessment. All HSC Trusts will review the outcome from the pilot along with the Commission’s views/advice before rolling the revised template out across the wider organisation and subject to SMT and Trust Board approval.

2015/16 Update:

HSC Trusts were mindful that the ECNI issued guidance, arising out of the Implementation of the Fresh Start Agreement, in relation to consultation timeframes i.e. Clause 65 ‘Engagement and Consultation’ refers. Essentially this is aimed at speeding up the policy development and decision making processes. The Trust’s Equality Manager attended a Commission led event on 26th April 2016 and the Trust subsequently submitted a considered response to the Commission in relation to the proposed amendments to consultation timescales.

The Commission has since considered the outcome of its consultation and has decided not to amend its advice and as such their advice will remain as it is currently, as an interim measure, pending a planned review of the effectiveness of the S75 duties scheduled by the Commission during the coming 3 years.

HSC Trust Equality Leads plan to undertake a review of their existing Equality Schemes and publically consult on revised Schemes during 2016/17 in preparation for the launch of new schemes and associated Action Based Plan to cover the period May 2017 thru May 2020/22. Current plans expire in May 2017.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 12: Equality Impact Easy to follow EQIA Increased satisfaction Year 1 HSC Trust Equality New Regional Assessment template that meets among policy leads and Leads in conjunction Action Template the needs of health decision makers when Monitored through with ECNI and social care. completing EQIAs. feedback from staff . Good practice To work with the using template and guidance ECNI to develop best All Trust policy guidance and Annual required to practice Equality makers will use S75 Progress Report to ensure Impact Assessment easy to follow EQIA Equality. consistent and Template. template. effective approach. Consistent approach adopted Source: Review of by all Trusts. Equality Scheme (ECNI)

Action 12 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

2015/16 Update:

HSC Trusts are committed to working with the ECNI to develop best practice in relation to EQIAs. During the year under review HSC Trust Equality Leads met with consultants engaged by the ECNI at Equality House in Belfast. The consultants were commissioned to undertake research into the experiences of public authorities in relation to S75 processes - notably equality screening and Equality Impact Assessment processes. HSC Equality Leads participated fully in the research and the discussion and also completed an on-line questionnaire. The findings from this research have since been released and will be used to inform future policy and practice in relation to equality screening and EQIA processes. Action 13: Multi-Identity Update Screening Increased awareness Year 1 and ongoing HSC Equality Leads Ongoing Regional and EQIA Tools to among staff of multi- Action To ensure that key ensure they are identity issues and their Monitored through multi-identity issues sufficiently sensitive impact on access to quarterly screening . Multi-Identity are incorporated into to include Health and Social Care. reports and S75 Annual Issues. Policy and Service assessment of Progress Report to Section 75 Action Based Plan - Appendix 2 – Page (30)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Developments. impact in relation to Improved screening and Equality Commission. multi-identity. EQIA processes. Source: ECNI Guide to the Statutory Duties (ECNI 2005) Rainbow (2014) Action 13 – Notes of Attainment: Action Completed – see Action 11 above

2015/16 Update: HSC Trust Equality Leads – as mentioned above - will undertake a review of their existing Equality Schemes and related processes namely Equality Screening and EQIA processes during 2016/17, primarily to take account of further guidance and outcome based related research commissioned by the ECNI. Revised Equality Schemes and related processes as well as new action based plans aimed at tackling inequalities will be issued in 2016/7 following a period of public consultation. This activity will be reflected in the Trust’s new Action Based Plan covering the period 2017-2022. Screening Guidelines to include a range and mix of worked examples including employment, procurement and service related. Action 14: S75 Training Updated training Increased awareness of Year 1 HSC Trust Equality New Regional programme policy leads and Leads Action To review S75 reflective of new decision makers on new Monitored through Training Programme screening and templates for screening feedback from staff . Need for so that it reflects any EQIA resources. and EQIA. using template and greater of the changes made guidance and Annual awareness to the screening and All Trust policy S75 Progress Report to amongst EQIA templates. makers trained in Equality Commission. Health and screening and Social Care EQIA resources. staff of Section 75 issues.

. Need to further mainstream

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Source: Guide to the Statutory Duties (ECNI 2005) Five Year Effectiveness Review Action 14 – Notes of Attainment: Action Completed

Feedback from the screening pilot and the Commission’s own related research – see Action 11 above - will further shape training resources and materials.

The Trust is committed to the provision of training as a key component of meeting its legislative requirements – see Chapter 5 of the Trust’s Equality Scheme. The Trusts’ Equality Leads deliver a range of training to ensure that staff are equipped with the necessary knowledge and skills to discharge the S75 equality duties – see training section of this year’s Annual Progress Report (point 24) for full range of training which includes e.g. corporate induction for new staff; S75 Equality Screening Master Classes for those involved in policy development and decision making processes of the Trust.   The Health and Social Care Discovering Diversity E-Learning programme, which now extends to 7 modules, continues to be rolled out to staff - *** staff have completed this to date.   2015/16 Update:   HSC Trust Equality Leads commenced work during the current reporting period 2015/16 to commission 2 further e-learning diversity modules – one for completion by all HSC staff and a further module specifically tailored for managers. HSC equality personnel i.e. both S75 Equality Leads and Employment Equality Managers from across all HSC organisations are currently working collaboratively on this latest initiative Section 75 Action Based Plan - Appendix 2 – Page (32)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) drawing on best practice available across the HSC and beyond. These latest 2 modules will include a greater emphasis on the good relations duty, human rights as well as anti-discrimination law and the S75 equality duties.   These latest modules should be available for launch – Autumn 2016. Action 15: Emerging Themes Up-to-date and Improved screening and On-going HSC Trust Equality Ongoing Regional reliable evidence EQIA processes. Leads Action - To annually review and staff resource Monitored through S75 and maintain the on emerging Better assessment of Annual Progress Report . Information ‘Emerging Themes’ themes in relation impact on S75 equality to Equality Commission. required to compendium of to key inequalities categories when allow service research literature to experienced by the planning and reviewing providers to inform current and nine equality services. identify key future action based categories. inequalities plans. and Collated data investigate (qualitative and their causes. quantitative) that is analysed, themed Source : Guide to the and disaggregated Statutory Duties by the Section 75 (ECNI 2005) categories.

Indicators of levels of inequalities. Evidence available for future screening and equality impact assessments. Relevant and evidence based action plan.

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Emerging Themes document was updated July 2015 and is available on all Trust websites and intranets.

2015/16 Update:

HSC Trusts updated Emerging Themes document in partnership with DHSSPS and will continue to review on an ongoing basis. HSCT Trust eagerly await the publication of the ECNI Key Inequalities in Health Document. Action 16: Maintenance of Up to date, relevant More effective and Annually. HSC Equality Leads in Ongoing Regional Regional list of consultees. targeted consultation. conjunction with other Action Consultation List Monitored through HSC organisations Revalidated Increase in consultation Annual Progress Report . Relevant up to To annually review consultee response rate. to ECNI. date regional list of database. information on consultees. consultees for engagement and consultation processes.

Source : Guide to the Statutory Duties (ECNI 2005) Action 16 – Notes of Attainment: Action Completed

2015/16 Update:

This list was updated again in May 2015 to support the Trust’s EQIA on ‘Proposal for the Future of Statutory Residential Care for Older People’. This task is ongoing i.e. reviewed annually. There are approximately 800 organisations on the master consultation list.

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Section 1 – Cross Cutting Themes Theme 4 – Promoting Participation and Inclusion

Recurring Theme Inequalities Audit – Lack of Involvement of S75 groups in planning and decision making

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Action 17: E-Learning PPI Multifaceted PPI Increased awareness Year 2 PHA New Regional toolkit awareness raising raising of PPI. Action - and training Uptake monitored Trust PPI Leads To work with Trust programme ranging Greater through E-Learning . Commitment to PPI Leads on the from Introductory understanding of monitoring process. HSC Trust Equality ensure PPI is development, launch level 1 to level 4 values, principles and Leads integral to and dissemination of specialised PPI methods of effective decision a multifaceted PPI training (modular PPI. making. awareness raising & and eLearning mix). Training Programme Greater Source : HSC Trusts for HSC in understanding of the Consultation partnership with needs of S75 groups Schemes Public Health Agency and how to effectively (PHA). engage with hard to Effective Stakeholder reach groups. Engagement - Good

Practice Guidelines (Policy Champions Will lead to an Network) increase in S75 Health and Social groups’ involvement Services (Reform) in planning and Northern Ireland Act decision making. 2009.

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New PPI Standards “Setting the Standards” was formally launched on 4th March 2015. These new regionally agreed standards set out the new PPI standards which HSC Trusts are expected to strive to implement as a model of good practice for developing PPI approaches to Health & Social Care. The five new standards are; Leadership, Governance, Opportunities and support for Involvement, Knowledge and Skills and Measuring Outcomes. A regionally approved Train the Trainer PPI programme has been developed and Trusts’ PPI Leads have received the training tools to allow for each Trust to roll out the PPI training locally. This will also be supported by the development of a PPI e-learning programme to complement the face to face training tools.

A regionally agreed PPI learning and development programme ‘Engage and Involve’ was officially launched 22nd February 2016. This consists of PPI Awareness e-learning and 8 taught modules - Introduction to PPI, Practical PPI, Communication and PPI, Facilitation skills for PPI, Getting people to participate in PPI, Measuring PPI, PPI Coaching and PPI Team Briefing. The e-learning programme has been made available for up- loading on to HSC Trust e-learning platforms, however, it is not yet available in SHSCT and the mechanism for the delivery of the taught modules has still to be agreed. The Trust has continued to deliver its own in-house PPI Awareness training opportunistically at team meetings and induction/professional development events. During 15/16 234 staff and 71 students received PPI training. Overall total of staff, students and volunteers trained in PPI at 31/1/16 = 1586.

2015/16 Update:

During the year under review i.e. 1st April 2015 – 31st March 2016 HSC Trust Equality Leads provided informed input to the revised HSC Consultation Scheme. In addition, HSC Equality and PPI Leads attended a regional Consultation Workshop on 15th March 2016 - the focus of which was to agree a consistent approach in relation to consultation arrangements for proposals that are considered to be major and contentious; proposals that are not major or contentious; and issues that require community engagement only. Action 18: Service User, Development and Increased Annual Progress Reports Carolyn Agnew Head of New Local Action Carers, Stakeholder implementation of involvement in User Involvement and Involvement Annual Directorate planning and decision Mid and end of year Community . Lack of PPI Action Plans. making of health care accountability reports to Development (SHSCT) involvement in Implementation of services. DHSSPS. planning and methodologies to Continued decision ensure involvement facilitation of Service User Panel / PPI Performance making by S75 of service users, service user and User Groups are Management reports to Section 75 Action Based Plan - Appendix 2 – Page (36)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) groups. carers and other carer led PPI representative of S75 PHA. relevant stakeholders Panel. groups. in planning and Quarterly reports to decision making of Continued Involvement of S75 Patient Client Experience health care services. facilitation of Carers groups at all 5 levels Committee. Reference Group of personal and Target recruitment of public involvement to Monitoring Arrangements marginalised/hard to Continued ensure inclusiveness Levels of representation reach groups. facilitation of Race and to Trust PPI activities Equality Forum and representativeness. across programmes of Traveller Action care. Group. Ability to influence the development of Summary of PPI Impact Range of methodologies to of involving Travellers involvement ensure involvement and carers following pilot activities under of service users, of PPI Impact template. annual Directorate carers and other PPI Action plans. relevant stakeholders S75 monitoring of PPI in planning and Reimbursement. decision making of health care services.

Increased involvement of carers in planning and decision making of health care services.

Increased involvement of Travellers and BME Section 75 Action Based Plan - Appendix 2 – Page (37)

2015/16 Update:

Directorate PPI Action Plans for 2015/16 have been developed and are being implemented. A PPI checklist exercise was undertaken to gauge compliance across POCs with the PPI indicators. The outcome report that is currently being developed will inform PPI Action Plans for 16/17 and the review and up-dating of the Trust’s PPI Strategic Plan and Consultation Scheme.

PPI Performance Management self-assessment completed as part of PHA PPI Performance management framework. A PHA PPI Verification visit was completed on 24/3/15 - focus on PPI in Cancer Services. The PHA published individual monitoring reports for HSC Trusts with specific recommendations under each of the PPI standards. The Southern Trust has actioned all of the recommendations possible as existing resources permit and has written to the PHA requesting additional resource for the areas that cannot be progressed:  Assign further resources to fulfil PPI responsibilities and the Statutory Duty of Involvement  Develop a central register of opportunities for involvement which is updated across all Directorates and readily accessible by the public.  Disseminate and roll out of the Regional PPI training programme and record up-take.

The PHA Report concluded that: On the basis of the evidence provided the SHSCT are the most advanced Trust in relation to complying with the Statutory Duty of Involvement and Consultation. PPI is clearly on the agenda of the senior management team and widely embedded within policy and practice in the organisation. The Trust has demonstrated leadership and has regularly shared good practice in this field across the HSC system. The strength of their commitment to service user and carer involvement has been demonstrated through its structures, through its monitoring and reporting arrangements and through the production of a wide range of support and guidance materials for staff and service users.

A further monitoring template for 15/16 has been issued for completion by 18th March 2016 with a verification visit mid April 2016. The proposed target area for 15/16 is Learning Disability services in hospital settings.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) PPI Research - two members of SHSCT staff were part of a research team with QUB, University of Ulster, Willowbank and peer service user researcher to monitor, measure and evaluate impact of PPI in HSC in NI. The final report which makes 10 recommendations for improving PPI within HSC in NI is currently with the PHA for approval.

The Trust’s PPI Panel continues to meet quarterly - an Action Plan for 15/16 has been completed and a 16/17 Plan is being developed. Four new members have recently been recruited and PPI Panel induction refresher training will be arranged for 16/17. PPI Panel members were involved in the Trust’s Quality Event Oct 15 and also assisted in the design and delivery on how to involve in design and delivery 2 PPI workshops – Practical Hints and Tips on Engaging Service Users and Carers attended by 43 staff at all levels across POCs. PPI Panel members worked with the PPI Team to develop a Good Meeting Etiquette checklist that has been made available on the Trust website and is being displayed in all Trust meeting venues.

Carers Reference Group continues - 15/16 progress report being developed and Action Plan for 16/17. Consultation process for development of new tender specification for generic carer support services completed and new provider to be appointed to deliver service from 1st April 2016. Community Development Carers Worker appointed July 2015 and directory of carer support services being finalised. This will feed into the work currently on-going in Access and Information regarding support services for older people and the wider Directory of Services project under BCBV.

 The work of the Trust Traveller Action Group has enhanced staff understanding of Traveller culture and needs and also the understanding of Travellers and Traveller Support Workers about Trust services and referral pathways. During 2015/16, the Trust secured funding from PHA to employ a Health Training Coordinator to develop a programme of accredited and non-accredited health and wellbeing training for Travellers. 16 Travellers completed Community Health Champion training accredited at Level 2 OCN and 1 completed Community Health Trainer training accredited at level 3 OCN. All participants received a range of non-accredited wraparound support training to meet their individual needs and equip them to volunteer as Community Health Champions within the local community and to be paid a sessional rate for their work as a Community Health Trainer. A further business case has been submitted and funding has been extended for a further 2 years to provide further support and mentoring those trained to embed, test and extend the model. It is anticipated that this model will assist in further raising awareness of the benefits of breastfeeding, screening, immunisation and making healthy lifestyle choices and increase understanding in the Traveller community about Trust services and referral pathways.

Self-Directed Support (SDS)

In addition to the 26 service users using SDS from the Southern Trust’s initial phase of implementation a further 3 are in operation with 15 in process. SDS is now available to carers and there are currently 4 carers using SDS with a further 12 in process. Section 75 Action Based Plan - Appendix 2 – Page (39)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Acute Directorate Patient Information Boards - each ward/unit in CAH will have a ‘Welcome Board’ with an information leaflet rack beside it. This board will have information on:  Who we are?  Sisters Charter  Images and names of all nurses  How we are doing  Hand Hygiene Audit  Environment  Patient Experience  Patient Support services  Chaplin service  Visiting times.

We value your views:

 The Butterfly Scheme - allows people whose memory is permanently affected by dementia to make this clear to hospital staff and provides a simple, practical strategy for meeting their needs. It also incorporates a system for offering that same response to people with temporary confusion. The patients receive more effective and appropriate care, reducing their stress levels and increasing their safety and well-being. Currently this scheme is being rolled out in acute and non-acute hospitals in the Southern Trust. In terms of staff training the hospitals have identified champions from Nursing, Medical, AHP, Domestic, Portering, Radiology, phlebotomy to attend a training session. The Butterfly trainer and 2 carers will deliver rolling 45 min sessions for ALL grades of staff to attend; staff will then confirm their learning by completing e certification. To compliment this scheme the hospitals are also delivering Patient Safety Briefing sessions, implementing Delirium Screening and are now Dementia Friendly Environments.  Ward Sisters Charter – Patients have information so that they know what to expect when they use Health and Social Care services (PPI Indicators). All Health and Social Care Trusts in Northern Ireland have been tasked to develop a commitment charter for patients, and the Southern Trust is currently implementing this as part of their overall patient information board’s initiative. There are the 7 commitments: 1. You will receive individual, safe, uninterrupted and high-quality care that meets your personal needs and is given by competent members of staff. 2. We will treat you with dignity, respect and compassion on a ward that is clean and safe. 3. We will behave with courtesy and consideration to your visitors. Section 75 Action Based Plan - Appendix 2 – Page (40)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) 4. You will know who you are speaking to. We will communicate with you confidentially and in a way that best suits you and your needs. 5. You will feel respected and listened to. You will have the opportunity to share your opinions about the care we provide. 6. Our decisions about your care will be made with you and with the people you wish to include. You will receive the information you need to make informed choices about your care. 7. You will be cared for by a team who are inspired by these commitments and have the authority to fulfil them.  PACE Framework - A framework to promote a person-centred approach to care supporting nurses to improve their record keeping practices. There are 4 interrelating components: 1. Person-Centred 2. Assessment 3. Care planning 4. Evaluation This person centred approach that respects and empowers, will promote partnerships and focus on prioritising people and their families/carers. Staff will be able to recognise and respect the contribution to care and ultimately it will promote the ethos of ‘contract of care’ with the patient - consent, understanding of care/treatment.  This is Me’ communication tool – A simple and practical tool that people with dementia and learning disability can use to tell staff about their needs, preferences, likes, dislikes and interests.  Bedside Entertainment (Mandeville Unit – Craigavon Hospital). Cancer services asked their patients what could be improved in terms of service delivery. Feedback from patient satisfaction was key to this project to provide a personalised bedside alternative to spending very long hours in the department with little distraction other than ward based shared TV, reading or sleeping. Clinical access to Trust applications via the provision of virtual desktop infrastructure was also possible making the service more person-centred. Patients can see their medical notes and results on screens which the clinician can discuss openly with the patient. Feedback from medical staff and patients who use the system has been extremely positive. The pilot provided valuable insight into patient / staff interaction with new technology.  Inflammatory Bowel Disease (IBD) Patient Panel: The Southern Trust set up an IBD Patient Panel in September 2013 to help plan and develop services for patients with Inflammatory Bowel Disease. Since it was set up the Panel has been gathering momentum, meeting with senior management and healthcare staff to share their experiences, highlighting the need for improved services across the Trust and helping to develop information resources. This helps to improve their experience from investigation, through to diagnosis and treatment. To date the Panel has been involved in a number of awareness and information sharing initiatives within the Trust and beyond. The Panel has also been involved with the Department of Health and links with Crohns and Colitis UK who help shape IBD services across the UK. Recently the IBD Patient Panel highlighted the need for improved emotional and psychological support. In partnership with the Promoting Wellbeing Mental Health Promotion Specialist a 6 week ‘5 Ways to Wellbeing’ training course has been developed and will take place end of February 2016. The Patient Panel has had an input into the design and delivery of the programme, patients who are participants will critically Section 75 Action Based Plan - Appendix 2 – Page (41)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) evaluate the programme. Feedback on course content will be taken on a weekly basis and evaluation forms and standardised tools will be used. Focus groups are planned with key stakeholders to discuss the impact of the programme on patients and on service development and delivery.  Cancer Service User Group – the group have been involved in helping plan, design the proposal for an information hub in Daisy Hill Hospital similar to the Craigavon Area Hospital site hub. The group work closely with the Macmillan Health and Wellbeing Coordinator and the Cancer Service Improvement Lead and are currently helping with a Quality Improvement project with in Cancer Services – ‘Improving Patient Experience in Cancer Services’. This project will run over 7 months and the service user group have been asked to sit on the project group. The group have recently discussed the common themes arising from the Peer Reviews and the Cancer Patient Experience Survey and have suggested areas where improvement in communications could be made. The need for on-going information and support after treatments ends was prioritised and the group are currently working in partnership with cancer services to progress this.  Maternity Service Liaison Committee (MSLC) – the Southern Trust’s MSLC service user members have worked with other MSLC service users and established a NI Maternity Forum (currently 276 members). The forum members consist of women who have used or may use maternity services and midwives. They have currently asked for a review of the regional MSLC Guidelines and have planned to establish a steering group to take this forward. The MSLC is also working towards the planned regional Home Birth Policy Review. In the meantime the group felt that the Trust information on Home Birth could be revised and have agreed to co-develop a leaflet and revise information on the Trust website.

Older People and Primary Care Directorate  Ongoing implementation of Trust Guidance on care of the dying patient - Guidance reviewed and signed off for use by the Palliative Care Experience Group and PPI panel. The Palliative Care Experience Group has also worked with the PPI team to help with the development of a service user leaflet for the care of the dying guidance. This is planned for completion by September 2016.  VERVE Network and Health Trainer Programme - For the past 3 years the Trust funded by the Department for Social Development has through its Promoting Wellbeing Department worked in partnership with a range of Statutory, Community and Voluntary sector agencies to implement a health programme that meets the needs of those living and working in 3 NR areas: Portadown, Lurgan and Brownlow. The model approach adopted and implemented by the Trust is based on the UK Health Trainer and Healthy Living Centre model. Working in partnership with 10 Community & Voluntary Sector organisations from within the 3 NR areas and supported by the Promoting Wellbeing Department’s NR Coordinator a Network of 10 healthy living centres was established; collectively known as the Verve HLC Network. Health activities delivered by Verve Healthy Living Centres were developed in response to community need and were flexible to be responsive to the changing health demands of that community “providing the right care in the right place at the right time “As well as developing an infra-structure through which community led health initiatives could be delivered the NR Health programme also incentivised innovation at a local level through the introduction of the Health Trainer programme. In total 20 local people were trained to a level where they have a focus on prevention and Section 75 Action Based Plan - Appendix 2 – Page (42)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) tackling inequalities. By placing the individual at the centre of the model we have achieved a better outcome for the service user, carer, and their family. Health Trainers have also been able to access Trust PWB training including Walk Leader, Cycle Leader, Cook It!, arm chair exercise etc. By building the capacity of the individuals from within the NR communities and in establishing a HLC Network, the NR Health programme has put in place a sustainable model of Community Health engagement. In line with the Department of Health’s strategic direction of Making Life Better this programme is supporting the conditions for individuals and communities to take control of their own lives, and is helping move towards a vision for Northern Ireland where all people are enabled and supported in achieving their full health and well-being potential.  Community Health Champions - Building on the successful model in Craigavon & Banbridge, the other 2 Trust localities have progressed a volunteer Community Health Champion model through their Neighbourhood Renewal and REACH workers with 40 local people trained. The role of the Health Champion is to voluntarily support people to transform their health and wellbeing by encouraging them to make healthy lifestyle choices, motivate them to get involved in healthy social activities and signpost to relevant supports and services.  Outcome Base Care, Domiciliary Care - Historically the domiciliary care budget within the Southern Trust was overspent and the Trust struggled to meet the growing need for domiciliary care services. The Older People’s division was aware that there were a number of issues with current service model employed including time for task, lack of timely review, creation of dependency, not flexible / responsive. In addition a domiciliary care worker stated “Where we are needed in a house we feel valued” which implies there were still homes that commissioned care was not considered necessary and could be tailored further. Work began to identify a better service approach with a greater focus on a quality service model involving those who currently use the service, their carers, the staff who delivered the service, managers and staff side. This inclusive approach resulted in:  Responsive, timely assessment  Greater efficiency achieved as care packages were flexibly tailored to meet eligible needs which freed up some capacity and allowed additional care packages to be accepted.  Improved outcomes – independence focus  Better collaboration – across Teams  Happy staff and clients – No complaints and positive feedback Pre-pilot questionnaires were completed for service users, staff, commissioners and further post pilot information will continue to be sought to enable comparisons with qualitative feedback and quantitative data to indicate successes to date. A planned phased roll-out across all of Armagh and Dungannon will enable further testing of this model at scale with a view to developing in all Trust areas. This will inform the procurement of the independent sector domiciliary care services and indeed involvement and engagement with providers as partners in care across the commissioner provider split.  New tender specification for generic carer support services - The views of carers were taken into account when developing the new tender specification for generic carer support services. The consultation process consisting of a questionnaire and series of consultation focus groups Section 75 Action Based Plan - Appendix 2 – Page (43)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) built on the process previously undertaken when the current tender specification was developed. The procurement process is now in its final stages and a new provider is being appointed to deliver the service tailored to the needs of those who will be using it from April 2016.  Implementation of Smoke Free sites across Trust area - Survey undertaken with service users, public and staff in 2014 re decision to proceed with Smoke Free. Service users invited to participate in 4 working groups to plan the implementation of Smoke Free. Union representatives also included in steering group and sub groups. Letters sent to all key stakeholders including those renting or sharing Trust accommodation, GPs, Pharmacy, dentists, MLA’s. Press releases, use of Trust Facebook and website to communicate plans to the public and promote smoking cessation support services.  Acute Care at Home-AC@H - The Acute Care at Home Service involves a range of healthcare professionals working together to help older people manage conditions such as chest infections, urinary tract infections, cellulitis and dehydration without the need for attending the emergency department, or being admitted to hospital. The team is led by a Consultant Geriatrician and includes a Specialty Doctor, Specialist Nurses, Pharmacist and has input from Occupational Therapy, Physiotherapy and Community Psychiatric Nursing. Following the implementation of the new service a flyer and an information pack were developed and service user and carers were invited to sit on the working group. Due to the nature of the clientele and the range of stakeholders involved a number of methods were employed to ensure comprehensive involvement. These included regular focus groups to discuss on-going service provision and seek the views of service users, carers and community/voluntary sector for future service developments. The development of a service user and carer questionnaire that was distributed to each patient/carer following team input. The development of a GP and Nursing Home Manager questionnaire which was distributed to each NH manager and GP through post, attendance at NH managers’ meetings, GP Forums, SALT: o 45 Service User and Carer feedback questionnaires o 47 NH managers questionnaires o 35 GP feedback questionnaires In addition there was a poster presentation at SHSCT Quality Improvement Event in Seagoe Parish Centre Oct 2015, a poster presentation at AMU information morning in CAH and a Quality improvement Breakfast Seminar hosted on 27/11/15. Feedback received will inform the further development of the service.  Modernisation of Stroke Services in SHSCT- Involvement in this service change included direct involvement of service users in Stroke Strategy Workshops to help develop standards for the Long Term Support for Stroke Sufferers/Carers and the gathering of feedback from service users and carers throughout the stroke care pathway (acute, non-acute, community & C&V phases) to inform the further development of the service. Progress to date includes:  The development of 3 draft patient surveys. Survey carried out January 2016  Development of carers/ stroke survivor feedback questionnaire  Stroke team staff attended community voluntary focus groups for feedback on service offered Section 75 Action Based Plan - Appendix 2 – Page (44)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)  Reconfiguration of stage 1 Stroke Association group to 12 weeks to increase engagement  Joint acute community stroke meetings  Trust Acute Non acute strategy stroke action plan  SSNAP audit ongoing  In reach by community stroke teams to non-acute multidisciplinary meetings with consultant access  Presentation by community stroke team staff to AD and Head of Service which included stroke survivor experience.

Mental Health and Disability Directorate  The Mental Health Forum Website - The Mental Health Forum was established in 1993 as a means of communicating mental health service user’s opinion to service providers and receiving information from service providers. Since that time the Forum has become the official voice of the service user community within the Southern Health and Social Care Trust. The Forum provides information, signposting and advice for service users, carers, professionals and the general public in relation to mental health services throughout the Trust area. The Forum engages directly with the Southern Trust in the planning, delivering and monitoring of mental health services both locally and regionally. Feedback from the Forum identified the need for further information and the idea of developing a website was borne. The Forum established a Website team and met for over a year to plan and develop the website. They linked with forum members, Southern Trust staff, community and voluntary groups throughout the planning period. The www.mentalhealthforum.co.uk website is now up and running. The site was conceived, designed, built and is run by service users themselves. The website offers support and information not just to service users, but to professionals and carers. Style and content have not been influenced by professionals and this is a true and unapologetic product of service user vision. The website exemplifies the power of personal recovery and the benefits of supporting service users as they identify and begin to utilise their strengths.  Recovery Stories Book – ‘Recovery, My Life … My Way Forward’ - The Recovery Stories Book has been co-produced by people with lived experiences of mental health difficulties, those who support them and the people who work in Mental Health Services in the Southern Trust area. In preparation for the book a range of people were asked to contribute their stories or indeed any piece of work that demonstrated their own personal journey. An amazing amount of work was sent in which made it clear that this was something really important to people. The other stories, poems and works of art that were not included in the book are available to view on the Mental Health Forum website and it is hoped to continue to create other mediums of expression as the Recovery work continues over the years. A Recovery Story Booklet has been produced as an insight into the lived experience of recovery for those who use services and their carers. The pieces of work are expressions of an inner journey for people who have mental health difficulties. The staff perspective is also really useful as there is an increasing awareness of allowing people who have challenges and difficulties to take back control of their lives so that they can live a more meaningful and rewarding life.  The review and modernisation of bed based short break provision (Respite) for individuals with a learning disability and their carers - Section 75 Action Based Plan - Appendix 2 – Page (45)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Carers have reported that access to regular flexible respite is very important in supporting their own health and wellbeing and enabling them to maintain their caring role. One of the significant concerns for the Southern Trust and carers was the provision of bed based short breaks to enable carers and service users to have access to equitable short break opportunities in the areas where they lived. Within Adult Learning Disability a robust and comprehensive consultation process has been undertaken where the views of the 348 individual carers on which this impacted were sought. Five consultation workshops were held across the SHSCT area. Additional feedback was sought from any carer who had not been at the Information Sessions so that they were given the opportunity to contribute to the future vision for short break services. All of the information which was gleaned from carers was used to inform an options appraisal as to the most effective form of bed based short break provision for service users and carers. The options appraisal was developed by a number of Trust staff working in partnership with 4 carers from the LD Carers’ Forum who had agreed to take part in the options selection process. The involvement of carers in this process helped Trust staff to have a greater understanding of the type of service they require. Carers also commented on the challenges being part of the appraisal process was for them and how detailed and transparent a process needs in order for it to be effective. Following the options appraisal and the selection of the preferred model, other carers from the LD Carers’ Forum agreed to take part in the development of the preferred model for respite. This has included several meetings to examine the physical environment of a new facility, arrangements for day care, transport and more importantly governance for that facility. Meetings have proven to be very informative from both Trust and carer perspectives but have maintained the value of the partnership as the underpinning basis for all discussions.  Annual survey in Supported Living Services - Tenants took part in an annual survey which is collated and viewed by RQIA. Positive feedback, clients feel listened to about the service they receive within their own home.  Learning Disability Transition Service (18-21 years old) - Reference Group involving service users, carers, independent sector established Sept 2015. Protocol developed and HSCB using model as basis for development of regional protocol. Recruitment for new Transition Team to be completed by Dec 2015. Development of 2 year plan to embed service being developed.  Learning Disability Crisis Response - Following feedback from service users and carers a Home Treatment Service to support service users and carers at home/placement for 48hrs preventing hospital admission and facilitating earlier discharge is being developed.  Future shape of Day Opportunities - In line with Transforming Your Care and the HSCB Consultation on Day Time Opportunities, all Trusts were required to review their day care provision and ensure that those who did not meet the criteria for day care could avail of a wider choice of day time activities to meet their needs. In developing the future shape of Day Opportunities within Southern Trust, feedback from earlier regional consultations on TYC, Bamford and the Physical Disability/Sensory Impairment strategy was noted. However to ensure the involvement of those most affected by the changing shape of day care in physical and learning disability in the Southern Trust, the Disability Division invited each service user and their carer/s and local voluntary and community organisations to attend an engagement event where Trust staff outlined the strategic direction and proposed changes and listened to attendees to hear their views on how the future of day Section 75 Action Based Plan - Appendix 2 – Page (46)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) opportunities should be shaped. A total of 4 engagement events were held across the Trust area with 284 attending. Following these events a report was developed and sent to all service users/carers with contact details given for follow up if required. In addition further discussions took place with service users in all Learning Disability and Physical Disability day care and there was also individual discussion with service users and families during annual reviews. Furthermore Heads of Service regularly attended the Learning Disability Carers Forum to provide up-dates and listen to feedback and continue to do so. Finally a letter was sent to all service users and carers providing an update on developments to date and inviting final comment. A total of 74 final written responses were received and this together with the feedback received from previous consultation and engagement events and activities is being taken into account in the development of the specification for the Brokerage service which will be tasked to identify and generate opportunities to suit a wide range of needs and interests.

Other achievements include: Advocacy - In 15/16 Learning Disability increased funding for Advocacy Services by 50%. Forensic assessment for speech and language - which is shared with PSNI to support service user understanding at police interviews and prevention to criminal justice system. Communication and Information - All leaflets and information within Learning Disability are in Easy read format. Children and Young Peoples Directorate  Enhancing Disabled Children’s Participation in the LAC Process Feedback from children and young people, their parents and carers and staff working within the Children with Disabilities Teams identified the need to improve children and young people’s participation in their Looked After Children’s (LAC) Review. To address this issue a review of current practice to identify where improvements could be made was initiated. Initially, information was collected from social workers working within the three Children with Disabilities Teams regarding the children and young people known to them that were involved within the LAC process. This information which provided baseline statistics was collated under the following headings: child’s ability to make a contribution, methods of communication/contribution used and if the child or young person regularly contributed to their LAC review. It became evident from the statistics that the vast majority of children and young people’s views were collated using social work observation of the child/young person at their placement, feedback from staff and discussions with parents/carers. The contribution forms used by social workers to engage with children and young people were also reviewed and it was found that they were dated and no longer fit for purpose, necessitating the development of a new range of child-friendly resources. It proved difficult to create a single resource that could be used with children and young people because of their varying levels of ability, and so a suite of resources evolved. A further challenge for social workers was providing children and young people with opportunities to participate directly in their review. As a direct result of the work undertaken, a range of tools suited to the varied ability levels of the children and young people was developed and included:  A photo album of each facility Section 75 Action Based Plan - Appendix 2 – Page (47)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)  Arts and Crafts kits  ‘I’ll Go First’ toolboxes  ‘I’ll Go First’ interactive CD Rom  Development of apps on i-pads  Workbooks / questionnaires  Using person centred formats  Standardised practice across CWD service  Increased involvement in care plans  Improved patient/client experience  Improved staff morale  Our Lives, Our Voice (OLOV) - LAC 12-15 year Service User Group - was established to provide young people with the opportunity to express their views, to be involved in shaping services for young people in care (now and in the future) and take responsibility for decisions that affect their lives. The group have met twice and have developed a terms of reference. Training needs have been identified to help support the young people to participate in the group and the young people have developed a draft action plan for 2016/2017. Their first action is to look at the process and structure of the LAC review from a young person’s perspective. Suggestions included developing a ‘quick guidance’ for staff for LAC reviews from the child’s perspective. A young person centred review of LAC reviews ensures that everyone, including the young person, will have the opportunity to have their say and puts the young person at the centre of the meeting, giving them ownership over the decisions that are made about their life.  Child Development Centre (CDC) – the CDC service undertook a survey of parents/carers who have attended the department. The results of this survey have helped the service to identify what they are doing well and they have identified aspects of the service that can be improved upon. One outcome of the survey has identified the need for a parent/carer group. The service advertised expression of interest in becoming a member of a parent/carer group. Around 8 parents expressed an interest and they have planned to meet in March 2016. The results of the overall survey will be shared with the group and an action plan will be developed to take forward any actions needed. Learning from the survey will also be shared with relevant staff to help them continue to make improvements for the benefit of patients.  Development of Protocol for Transition – new protocol for transitions was co-developed in partnership with the 19 Plus Lobby Group.  Review of Short Breaks for children with a disability – The service wanted to ensure that developments of short breaks services in the Southern Trust area truly reflected what service users and their carers want and need. A questionnaire was developed and shared widely among all who avail of short breaks to find out more about the types of short breaks used and the overall experiences and views with regards to short breaks. The perception of short breaks is changing and it now refers to any organised meaningful activity for a child or young person who provides a break from caring for parents/carers. A parent information day was held in Gosford, Markethill in September 2015 to continue to involve and share information with parents and carers on the developments within short breaks. Section 75 Action Based Plan - Appendix 2 – Page (48)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)  Community Dental Service – the service has taken on board suggestions from service users who completed questionnaires on how programmes could be improved; this was achieved by providing more equipment to run the programmes more efficiently and smoothly. Service users were informed of this progress and thanked for their feedback. Community Dental Leaflet (Dementia and Oral Health) revised.

The Trust has undertaken a self-audit checklist exercise to determine compliance with its PPI Indicators across all Directorates and anticipates that the results of this exercise will be available by the end of March 2016/early April 2016. This will indicate areas where teams are compliant and identify where additional support is required. It will not however assess the quality of compliance. The Trust has commenced a review of its PPI Toolkit.

PPI is a standing agenda item on the Trust Patient Client Experience Committee, which is a subcommittee of the Board and reports directly to the Trust Board. Each Trust Board meeting has an agenda item which focuses on a patient/client centred service which includes feedback and learning from PPI activity using feedback from both health professionals and service users. The focus in going forward will be to update the Trust’s PPI Strategy, the PPI toolkit, HSC Consultation Scheme - Flowchart, the provision of practical support to further mainstream the Trust’s PPI obligations across the Trust’s Directorates, together with the provision of staff training. These activities will be picked up and reflected in the Trust’s new Equality Scheme Action Based Plan covering the period 2017-2022. Action 19 Patient Client DHSSPS Greater than 90% Monitoring Arrangements Fiona Wright New Local Action Experience commencing PCES compliance with each Monitoring quarterly to AD Nursing Governance audit programme of the 5 standards. PHA.  Patients Implementation of 14/15. accessing methodologies to Carolyn Agnew Head of services can record patient client Phase 1 In-patients User Involvement and experience experience across a May/June 2014. Community poor attitude / range of facilities. Development (SHSCT). behaviour / Phase 2 ED respect / Dec 2014. communication/ privacy and PHA dignity from 14/15 Work plan. staff. Quarter 1 Review PCES Audit Source: DHSSPSNI programme 2009 - Section 75 Action Based Plan - Appendix 2 – Page (49)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Patient Client 2014 and identify Experience Standards areas for improvement. Develop Improvement plans and agree Key Improvement Initiative

Quarters 2, 3 & 4 Actions to improve issues identified. Continue to monitor progress on regional PCES priorities.

15/16 Work plan - as for 14/15 but with different agreed areas based on feedback from 10,000 Voices and NQI Action 19 – Notes of Attainment: Action Completed

DHSSPS PCES in-patient audit circulated – Audit Report published. No further audits planned.

Trust PCE Work Plan14/15 agreed. PCES Improvement Plans developed for key areas of non-compliance and being implemented. Quarterly progress reports submitted to PHA. #hellomynameis has been launched 23/10/14 as Trust key improvement initiative. 10,000 Voices Phase 1 Unscheduled Care completed - action plans have been developed and are being implemented. Phase 2 Care of 10,000 Voice i.e. in the Home Section 75 Action Based Plan - Appendix 2 – Page (50)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) completed.

Recurrent funding was secured for Band 6 10,000 Voices Support Worker in 2015/16. Discussions commenced internally and regionally regarding interfaces between PPI and PCE and streamlining of monitoring and reporting mechanisms. 2015/16 Update: Please refer to Appendix 3 for 2015/16 update. Key milestones for the lifespan of this plan which covers the period 2014-2017 have been fully achieved.

Section 75 Action Based Plan - Appendix 2 – Page (51)

Section 1 – Cross Cutting Themes Theme 5 – Procurement

Recurring Theme Inequalities Audit – Those organisations that Public Authorities contract with should be required to have equality policies and procedures in place in relation to the delivery of their services.

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 20: Procurement – Training sessions Increased awareness Year 2 BSO Ongoing Regional Section 75 Duties delivered to among relevant HSC Action - relevant HSC staff. staff of S75, Disability Uptake monitored HSC Trust Equality To continue with on- Duties and Human through training Leads . Need for going training Evidence of S75 Rights obligations in programme. consistent delivered by BSO to considerations in procurement process. compliance HSC staff involved in HSC procurement with ECNI contracting and process. guidance commissioning Equality of function to ensure Opportunity S75 duties are and embedded in the Sustainable procurement Development processes and to in Public promote an Sector increased awareness Procurement. of Human Rights in Procurement. Guide to the Statutory Duties 2005

Public Procurement and Human Rights in Section 75 Action Based Plan - Appendix 2 – Page (52)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) NI (NIHRC) Equality of Opportunity and Sustainable Development in Public Sector Procurement 2008 Action 20 – Notes of Attainment: Action Completed

2015/16 Update:

A regional workshop took place on 14th August 2015 focusing on Equality and Human Rights Issues in relation to Procurement, Commissioning and Planning processes. Good practice examples and legal implications were discussed at the event. Invitations were extended to all HSC organisations. Staff from Performance and Reform and Contracts Management functions, Trust Equality Leads as well as service managers et al were in attendance. Inputting to the event was June Turkington, Directorate of Legal Services, BSO and Orla Donaghy, Procurement and Logistics Services (PaLs). Following on from this similar workshops were held in each of the HSC Trust geographical areas. A workshop took place in the Southern Trust area on 12th November 2015 and was attended by staff from the PHA, HSCB, Trust and BSO. The workshop was well received as reflected in the feedback from participants.

Section 75 Action Based Plan - Appendix 2 – Page (53)

SECTION 2

Service Related Issues

Measures to promote equality of access to Health and Social Care Services Pages 55 - 84

Section 75 Action Based Plan - Appendix 2 – Page (54)

Section 2 – Service Related Issues

Recurring Theme Inequalities Audit – Measures to promote equality of access to health and social care services

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 21: No Recourse to Guidance updated Northern Ireland Year 2 HSC Trusts, BSO, Ongoing Regional Public Funds for staff to use Entrants Scheme DHSSPS, HSCB Action - during decision (NINES). Monitored via BSO, To ensure that making. Counter Fraud Unit . For persons in decisions in this area Increased staff and Trust internal need who are are compliant with Staff informed of awareness of key monitoring destitute and key legislative Guidance. considerations when arrangements. have no or requirements e.g. determining if limited Human Rights Act. treatment or support recourse to can be provided. public funds.

. Current constraints include lack of regional guidance and funding implications. Source: No Home

Section 75 Action Based Plan - Appendix 2 – Page (55)

Policy Briefing Accessing Healthcare for Migrants in NI: Problems and Solutions, Law Centre (NI) (2013)

DHSSPS Consultation on 2005 Provision for services to Persons not ordinarily resident in NI (2013) Action 21 – Notes of Attainment: Action Completed

2015/16 Update:

The Counter Fraud & Probity Services set up a Pilot in 2 Trust areas i.e. the Western and Southern Trusts. The outcome of these pilots were evaluated to assist with next steps to be taken across health and social care sector. The Pilot involved a process whereby patients who presented without GP details or a Health & Care Number are asked to provide proof of residency – leaving it up to the patient to prove residency and not the Trust. Patients were asked to provide photographic ID along with a further piece of evidence to confirm residency. Trust Equality Leads have provided feedback and will continue to provide advice to ensure HSC Trusts equality and human rights obligations are met. Learning has been gleaned from the pilot and feedback received which has informed the training and resource materials that are being rolled out by the BSO Counter Fraud & Probity Service to relevant HSC staff.

On 28 May 2015 an event entitled “Domestic Abuse and Women with No Recourse to Public Funds: Where Human Rights Do Not Reach” was held to celebrate Africa Week by raising awareness on issues affecting Black Minority and Ethnic Women in Northern Ireland. It brought together Women’s groups, NGO’s, policy-makers, victims of domestic violence, service providers, health practitioners and other public bodies to share information and establish a collaborative approach to addressing the issue of “Domestic Abuse and Women with no Recourse to Public Funds” in Section 75 Action Based Plan - Appendix 2 – Page (56)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Northern Ireland as it impacts on the protection of children and vulnerable adults. Trusts will consider the outcome from this event to ensure compliance with best practice.

The Stronger Together Network also held a seminar on 24 June 2015 to discuss the implications faced by people that have no recourse to public funds and how they can be supported by the community and voluntary sector. The event agenda included what ‘No recourse to public funds” means and who it applies to, understanding the legislation and short, medium and long term support solutions. Outcomes from this event will be considered and during 2015/16 Trust Equality Leads will consider how Trusts can work in partnership with the voluntary and community sector.  The Red Cross was awarded crisis funds to distribute on behalf of OFMDFM for December 2015, January 2016, February 2016 and March 2016. The Fund of up to £55,000 this financial year is intended to help minority ethnic individuals with no other means of support through emergency situations, for example, vulnerable migrants, refugees and asylum seekers and other vulnerable groups. Junior Minister Jennifer McCann said: “The Fund aims to provide short term, emergency financial assistance to vulnerable groups such as refugees, asylum seekers and migrants who are facing destitution. The Red Cross will be administering the Fund and their experience in the field of crisis relief and local knowledge makes them ideally placed to help people on the ground. The Red Cross is working alongside partner organisations such as NICRAS to administer the fund. The Minority Ethnic Development Fund (MEDF) continues to support many of these partner organisations in their long-term efforts to end disadvantage and destitution”. Action 22: Multi-cultural and Updated Multi- Improved patient Year 1 Southern Trust on behalf of Ongoing Regional Beliefs Handbook cultural and Beliefs experience for BME all HSC Trusts Action Handbook available communities. Monitored through To maintain the for staff. PPI/Patient . Need for Multi-cultural and Increased awareness Surveys/Complaints culturally Beliefs Handbook to Provision of among staff of beliefs, monitoring. sensitive ensure that reflects culturally sensitive needs and services. current migration services. preferences. trends. BME service users NICEM Report Black treated with dignity and Minority Health and respect and Wellbeing regardless of their Development Project ethnic background. September 2006.

Section 75 Action Based Plan - Appendix 2 – Page (57)

New to NI – A study of issues faced by migrant, asylum seeking and refugee child in NI Action 22 – Notes of Attainment: Action Completed

2015/16 Update:

Designed to assist staff in ensuring they provide culturally sensitive services in their day to day work this regional resource, which is maintained by the SHSCT on behalf of HSC Trusts, was updated during the current reporting period to reflect recent changes to the provision of the interpreting service (now managed by the BSO on behalf of the HSC family) and to reflect the growth in diversity of the NI population profile. This newly revised resource is available on the Trust's intranet and now includes information on the Roma community.

Other notable amendments include updates provided by NI Chaplaincy Service to the Jewish section and amendments necessitated by the deployment of the new IT web based Portal for the booking of interpreters – section 6 of this resource refers.

Action completed for the lifespan of this plan i.e. 2014-2017. This action measure will however be subject to on-going review to reflect migration trends. Action 23: Age Discrimination Workshop with Increased staff Year 3 Service Leads New Regional Regulations service areas to awareness of (dependent on Action identify issues. legislative requirement. legislation HSC Trust Equality Leads To work with Trust enactment). . Need to service areas to Actions developed Section 75 Action Based Plan - Appendix 2 – Page (58)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) ensure Trusts identify the key to ensure Trusts Monitored through prepared for issues to address in are prepared for action plan and S75 extension of preparation for extension of Annual Progress Age extension of Age regulations. Report. Discrimination Discrimination Regulations. Regulations into the Good practice sphere of goods, adopted across Source: Old Habits facilities and service areas. Die Hard – Tackling services. Age Discrimination in Health and Social Care

ECNI - Awareness of Age Regulations 2006 and Attitudes of the General Public in Northern Ireland towards Age Related Issues Action 23 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

Legislation has not yet been introduced as yet however note below announcement made by Junior Ministers by way of background:

Junior Ministers Jennifer McCann and Jonathan Bell announced proposals on the way forward for new age discrimination legislation on the provision of goods, facilities and services - Thursday, 19 February 2015. The Programme for Government contains a commitment to extend legislation to give legal protection from unfair age discrimination by those providing goods, facilities and services. The proposed legislation will apply to people aged 16 and over. Junior Minister McCann said “The aim of the new legislation is to protect all people aged 16 and over from discrimination because of their age when accessing goods, facilities and services. This will put age discrimination outside work on a similar footing to discrimination law in employment. It sends out the clear message that ageist attitudes and practices are as unacceptable in service provision as in the workplace." Junior Minister Bell commented: “We are eager to progress this Programme for Government commitment as soon as possible. It will give individuals confidence to know their rights to fair treatment, and provide legal clarity for service providers. The next step will be to bring Section 75 Action Based Plan - Appendix 2 – Page (59)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) forward a consultation document in the near future, setting out our proposals. Following consultation, we will then consider all the options available to us for bringing this legislation before the Assembly.”

In certain circumstances it is appropriate to treat people differently because of age, such as the prohibition on the sale of alcohol to people under 18. The proposals will not affect other legislation which currently imposes statutory age limits. At the time of completing last year’s annual report OFMDFM had announced the commencement of public consultation on the Proposals to Extend Age Discrimination Legislation (Age Goods, Facilities and Services) from 3 July 2015 – 8 October 2015.

2015/16 Update:

Equality Leads discussed the impending GFS Age Regulations at their Regional Equality and Human Rights Steering group meeting on 7th October 2015. HSC Equality Leads believe there are a number of reasons for suggesting a joined up approach by the HSC family in anticipation of this new legislation namely: (vii) Preparedness – it was evident from the presentation by Dee Masters, Cloisters at the ‘Strengthening Protection for All Ages’ event (hosted by the ECNI, 27 August 2015) that preparedness had stood the health sector in GB in good stead – there were few if any challenges under the new Regulations to date. (viii) Equality Leads would advocate a collective, top down, bottom up approach for reasons of thoroughness/robustness i.e. involving the whole sector – similar to the aforementioned GB approach - if only to rule out quickly where the new Regulations are unlikely to have an impact and to focus our collective efforts on areas of greatest risk/impact. (ix) Equality Leads are also in support of exploring the use of a single robust audit tool for reasons of consistency to highlight where age or age criteria are in use within the sphere of GFS. (x) Having identified where age or age related criteria remain in use this could be examined more closely to see if its continued use is capable of being objectively justified in all the circumstances and that it is in fact in the best interest of the patient/client etc. (xi) Equality Leads would be happy to feed into this process and are keen to tap into any available tools together with the earlier experiences of our GB colleagues. (xii) Involvement of others* - advice could be sought from DLS re the robustness of any objective justification test necessary for the continued use of age or age related criteria – preferably in advance of the legislation being enacted. *There may also be merit in engaging/tapping into the expertise of the Age Sector given their extensive knowledge and expertise in this area and in order to anticipate possible areas of challenge and remedial action.

Section 75 Action Based Plan - Appendix 2 – Page (60)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 24: BME Carers Initiatives identified Raised profile of the Year 1 Regional Minority Ethnic New Regional to reach out to and issues affecting BME Health and Social Well- Action To develop ways of to support BME carers in NI. Monitored through Being Steering Group identifying and carers. At a identifying and . Support for supporting BME practical level this Increase in staff supporting BME PHA Black and carers by working in work includes: awareness of the carers group. Minority Ethnic partnership with Information leaflet needs of BME carers. Trust Carers Co-ordinators (BME) Carers. health and social translated into 9 care organisations, languages. Improved information HSC Trust Equality Leads Source: Diversity in community and Training event for available for BME Caring. Towards voluntary groups and health and social carers. equality for carers, others seeking to care staff to be run Yeandle, Bennett, improve the health during Carers Buckner, Fry and and social wellbeing Week 2014. Price, University of of BME carers across Good practice Leeds Northern Ireland. shared across organisations working with BME carers. Action 24 – Notes of Attainment: Action Completed

Previous regional initiatives to support BME carers during 2014–2015 included:  Development of an information leaflet aimed at raising awareness of carer support and details of Carer Co-Ordinators translated into 11 languages and launched at a regional event in June 2014 in the SHSCT. This leaflet was distributed throughout all HSC Trusts and is available on the Trust website.  Funding was secured by the Regional BME Carers group (from PHA) to run events in each Trust to raise awareness of BME carers. Events included:  A workshop ‘Cultural Approaches to Caring’ which aimed to raise awareness of cultural differences to caring, and to provide a networking opportunity between the Trust and other organisations supporting BME carers. Cancelled due to lack of interest.  A seminar for BME organisations on Carer support – Cancelled due to lack of interest.

Section 75 Action Based Plan - Appendix 2 – Page (61)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)  Funding has been sought by the Trusts’ Carers Co-ordinators from PHA to conduct research into BME Carers. This research will help to establish a baseline of BME Carers throughout NI and help identify their needs and plan for future services. One of the key objectives of the research application is to develop a support network for BME Carers and further promote social inclusion for BME Carers and their families. SHSCT circulated scoping questionnaire and forwarded information to research lead by deadline of 31/1/16. 31 BME carers identified in SHSCT. Awaiting report.

2015/16 Update:

The Trust’s Carers Reference Group continues - 15/16 progress report is being completed as is an Action Plan for 16/17. Carers resources have been translated into top 12 languages to increase accessibility to support services. Final copies have been made available on the Trust website. 13,000 booklets and 13,000 leaflets were printed and a number of attempts made to circulate hard copies however very low up-take. Circulation to 84 BME groups and internally circulated across POCs. Specific targeted approach to Sure Starts, CAB, Jobs and Benefits offices, libraries, professional leads for Midwifery and Health Visiting. Total of 850 leaflets and 1,454 booklets requested (including 300 English). Database of carers being developed so that information can be emailed/posted to all registered carers in SHSCT. Carers Register leaflet and application developed and leaflets and pop-up stands being printed. Initiative to be launched at Carer’s Health Check and information day 31st March 2016.

Funding for Community Development Carers Worker has been extended until 30/9/16.

The BME Carers Strategy Group have been involved in a research exercise into the landscape of BME Carers in Northern Ireland which represents a first step towards establishing a Northern Ireland-wide BME Carers Subgroup strategy and plan of action for the coming years. The rationale for the research is to attempt to establish and prioritise future activities for the benefit of the BME carer community across all Trust areas. It is anticipated that the final research report will be launched on 2nd June 2016. Action 25: Childcare Provision Develop and Increased provision of Research launch SHSCT Working group and New Local Action implement SHSCT flexible, affordable 12/3/14 NICEM. Membership to Increased provision action plan to childcare. include: . Lack of of flexible, affordable address Working Group Carolyn Agnew, Head of specific childcare. recommendations Public information established April User Involvement and childcare and of NICEM/ campaigns on 2014, terms of Community Development; information to Increased numbers Barnardo’s “Believe childcare which also reference and action Bronagh Shields,

Section 75 Action Based Plan - Appendix 2 – Page (62)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) meet the of registered child in Childcare?” target information to plan developed in Health Visitor; Lynda needs of BME minders from BME research report as those that have limited year 1. Gordon, Head of Equality; communities. communities. they pertain to or no written or spoken Ciaran Eastwood, Southern Trust. English language. Actions to be Head of Early Years Source: Believe in implemented over Childcare? Believe in Liaise with NICEM Increased numbers of the lifespan of the Outcomes to be shared Children. NICEM and and Barnardo's to registered child current plan across HSC Trusts Barnardo’s NI develop action minders from BME 2014/17. plan. communities. An investigation into Invite representative the childcare needs of ethnic minority from Early Years to communities in NI join Race Equality March 2014 Forum.

Monitor increase in provision of flexible, affordable child care and increase in numbers of registered child minders from BME communities. Action 25 – Notes of Attainment: Action Completed

Initial Meeting identified the following key for development of the action plan include:

 Communication  Training  Social Economy Models  Monitoring & Evaluation

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) The Early Years Service has also currently completed an Article 20 Review which is a statutory requirement to review the provision of childminding and day care in the Trust area every three years. A representative from the Trust’s Childrens and Young Person Directorate also attended the Trust’s Race Equality Forum to seek the Forums views on ways to reach and attract more Foster Cares from the local BME community – see main body of the year’s report for further detail. Action 26: Screening Services Promote informed Improved access and 2012 - 2015 HSC Board, Public Health New Regional choice in cancer greater uptake to Agency, HSC Trusts, GPs Action Action plan to screening. cancer services by and regional working group improve uptake of S75 groups.  Low uptake of cancer screening Work with external cancer services. representatives and screening hard to reach services by groups to promote some S75 cancer screening groups. services.

Source: Public Health Agency 4-year Regional Action Plan 2012-2015 Action 26 – Notes of Attainment: Action Completed

2015/16 Update:

During 15/16 Traveller Support Groups identified Traveller women aged 50+ and continue to raise awareness and provide support and encouragement to up-take breast screening

Travellers are one of the groups of people who are historically low attenders of cancer screening. This was discussed at the regional Travellers Health and Wellbeing Forum and it was agreed that a pilot would be undertaken in the Southern Trust area to provide special breast screening clinics arranged on a date and location to enable groups of Traveller women to attend together for breast screening. The aim of the pilot was to facilitate special breast screening clinics for Traveller women and also to raise awareness of breast cancer and of the breast screening programme. Section 75 Action Based Plan - Appendix 2 – Page (64)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)

There was support and enthusiasm from the Southern Trust Breast Screening Unit who have arranged specific breast screening sessions for Travellers in the past. A project team, including Trust staff and Traveller Support Workers, was established to oversee the facilitation and delivery of the breast screening clinics and engagement with Travellers. The clinics were arranged for November / December 2014 when the Southern Trust had taken delivery of new mobile screening units with digital mammography. The mobiles replaced the previous analogue mammography equipment and offered a higher quality screening experience.

Out of a total of 37 eligible Traveller women 5 attended, and 8 who had booked appointments did not turn up. While the numbers were low, there was a good spread across the area.

Reasons for women not attending clinics or cancelling at the last minute:  Anxiety and a fear of cancer.  A fear of knowing that something is wrong.  The clinics were arranged too close to Christmas.  Women from Dungannon had previously attended breast screening.  Sick relative so could not make it.  If appointments are on a Monday morning the Traveller Support Worker has little time to remind and organise the women.

Feedback on the clinics from those attending:  Would not change anything, the clinics were organised very well.  Staff at the breast screening unit were very nice.  The Breast Care Nurse was excellent and crucial to the positive experience.  It is very important for the Traveller Support Worker to be in attendance with the women.  Results letters should be tailored for Travellers.

Feedback from the screening unit:  The Breast Care Nurse was highly valued. The nurse would not normally attend breast screening clinics.  It had a significant impact on her time as she was travelling for clinics with one or two women. If all of the women could be screened in one session it would help, however, the unit appreciated the need to have different clinics for different localities.  The Traveller Support Workers were key to the women attending. Section 75 Action Based Plan - Appendix 2 – Page (65)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)

Views on attending for breast screening in future  All women said they would attend again and would encourage others to attend.  Traveller Support Workers believe some women would attend following a normal screening invitation, but others would only attend if it was a special clinic arranged again for Travellers.  Travellers have a lower life expectancy so the screening age should be reduced to 40 for Travellers.  “My husband has completed his bowel screening kit on the back of me attending breast screening.”

NB: Learning from this pilot was shared with other HSC Trusts. Action 27: Community Development and Reduced health Annual Progress Carolyn Agnew Head of Ongoing Local Development Plan implementation of inequalities and Report. User Involvement and Action annual Community disadvantage and Community Development Reduced health Development improved access to HSCB Community (SHSCT). . Promotion of inequalities and Action Plan. services. Development equality of disadvantage and Performance access to improved access to Capacity building. Management health and services across all Framework. social care population groups Development of new and other including: services to meet support identified need. services for Older People S75 Groups. Children and families Carers BME Communities People with a Disability Volunteers.

Section 75 Action Based Plan - Appendix 2 – Page (66)

2015/16 Update:

In 2015/16 a Health Improvement action plan for people with a learning disability was developed and delivered to support improved health and wellbeing need of those with a learning disability. An ‘I Can Cook It’ training programme has been developed regionally with tailored easy read resources included to make this programme accessible to those with a learning disability. Locally the SHSCT has trained 17 facilitators including Trust staff and Voluntary sector organisations who work with people with a learning disability. Three ‘I can Cook It’ programmes have been provided with 48 participants in week 1 and 41 participants completing programmes in week 8.

The PWB team has worked with the Northern Ireland Abdominal Aortic Aneurysm Screening Programme (NIAAASP) to support the planning and delivery of AAA screening clinics in non-clinical community environments to encourage men who may not otherwise attend for screening.

In Craigavon Neighbourhood Renewal area a screening clinic was held on 18th February and 19th February at the Verve centre, Drumcree Community Trust in Portadown. In total 50 men participated and received this valuable screening. Health Trainers from the Verve health living centre attended on the day to provide health checks and health promotion information and stands tailored to men’s health issues.

A screening clinic was also held on 17th of February in Drumellan Family Learning Complex, Craigavon and was supported by the on site NR Health Trainer who provided health promotion advice and health checks at the event. 8 men attended and 6 screenings were completed as 2 men had previously been screened. Action 28: Establish Age Community Gerard Rocks, Assistant New Local Action Friendly Pilots Development and Director of Promoting Health Improvement Wellbeing (acting) (SHSCT). . Poor social Work in partnership Development of Increased awareness progress reports supports for with PHA and local directory of of existing social older people in Councils to develop services that support available for the community action plans to support older older people, and reduced address gaps in people. development of new access to provision identified provision to meet services that by Community identified need. increase Conversations. Development of Increased access to Section 75 Action Based Plan - Appendix 2 – Page (67)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) independence action plans to services that increase at home. address gaps in independence at Further development provision. home. of Access and Source : Baseline Information Service Implementation of Extension of A&I study for the CAWT as single point of action plans. services across all Older Peoples contact for referrals ICTs Project to older people Evaluation of pilots services. and lessons learnt. Continued support Recruitment of Progress reports. Carolyn Agnew Head of for development and additional 0.5 WTE User Involvement and implementation of A&I Officer and 4.5 Community Development Mind the Gap – Big WTE A&I Support (SHSCT). Lottery funded Officers. project led by Carers Trust. Further roll out of Big Lottery A&I service to all monitoring Continued provision ICTs and requirements. of British Red Cross Reablement Teams Care in the Home trust wide and then Scheme. to include ICS, pilot OT in Armagh ICT and District Nursing Quarterly monitoring Carolyn Agnew Head of Identification and reports. User Involvement and signposting of older Community Development carers not currently Monthly monitoring (SHSCT). known to services. returns Patricia McCrink Carers Volunteer support Coordinator for vulnerable Section 75 Action Based Plan - Appendix 2 – Page (68)

Professional Support for Clients Lynne Smart referrals to British over 55 on discharge Head of Health Redcross Care in from hospital or for Improvement (SHSCT) the Home Scheme community support to Brenda Toal reduce admission Promoting Wellbeing rates. Specialist Lead(SHSCT). Action 28 – Notes of Attainment: Phase 1 - Action Completed

Previous achievements included : Searchable database of services that support older people developed and being used by Access and Information Team. Ready to be made widely available on Older People and Primary Care (OPPC) SharePoint. To be included in wider Trust DoS BCBV project.

Community Conversations completed, evaluation reports and action plans developed, feedback sessions held with local people in pilot areas. Steering Group established and local implementation groups established to implement agreed actions. Launch of Age Friendly initiative took place in Newry and Mourne 6th October 2014 - Action Plan, Leaflet, Older Peoples Forum and Website launched.

Access and Information - Further 3 Band 4 Access and Information (A&I) Officers were appointed in January 2015 and induction training was completed at the end Feb 2015. PARIS implemented and A&I working with new system to get best out of it. Roll out of A&I Service - going live with ICS with current A&I electronic processes 13/4/15. Plan for ICS to go live with PARIS 20/4/15. Reablement - preparation for all teams to go live at end May 2015 dependant on staffing in Reablement Teams being in place. ICT SW – awaiting date for PARIS from Community Information Systems Team. District Nursing - scoping commenced. This will be a significant undertaking and will lead to GP referrals. Additional 2 staff have been requested.

Mind the Gap - Expert reference group meetings attended on quarterly basis. Links in to the Good Day Good Carer service to share information with carers on upcoming events and training when available. Links to Mind the Gap Outreach support worker for the Southern Trust, to advise and signpost for services.

2015/16 Update: Section 75 Action Based Plan - Appendix 2 – Page (69)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Older People’s Workstream Steering Group established and local implementation groups established to implement agreed actions. During 15/16 the following projects have been progressed in pilot areas:

 Dromore: Christmas lunch for 76 older people.  Dementia training for Business owners and local shop keepers.  Transport scheme – 32 people signed up to the DART scheme with 11 Volunteer drivers to take part in the training.  Establishment of Luncheon club in partnership with Tesco and “The Right Key” group.  Launch of local directory of services planned for 1st Feb 2016.  Site visits to the Somme Centre/Palace stables.

Church & Court (Craigavon)  Development of pop up information stations and the older person’s ambassador role.  Development of News Letter for older people.

Kilkeel South & Central (Newry & Mourne)  Transport scheme on-going, additional monies secured from Council.  Social inclusion/participation element of the project continues with o food safety o digital media and o Governance training being delivered.  Age Friendly conference held in Oct 15. 300 older people in attendance with over 50 stand holders providing a range of information and support for older people.

Keady, Carrigatuke & Derrynoose (Armagh)  ‘Health is your Wealth’ 7 week programme included Yoga, positive mental health, Cancer awareness - from this there has been a weekly yoga class that has continued in the centre.  Reminiscence event in Dunlarg Nursing Home. Intergenerational aspect included young people from Keady Youth Forum. Hosted by the Nursing Home, range of activities.  Signposting to local IT classes – delivered by SRC and the FACT project. This was basic programme, based around using tablets and iPad’s. Second programme commenced in January 16.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)  Community cinema – first showing 8th December 15. 10 people attended. Second scheduled for February 16.  Continuation of luncheon club on a monthly basis. Usually around 20-25 attending. Two course meal with tea/coffee £5pp.  Handyman Scheme – SVP. Recruitment of new volunteer. Funding for marketing material and volunteer expenses. 11 people used the service between 11 Nov 2015 and 31 Dec 2015. Jobs included gutter cleaning and clearing driveway. Received further £1,000 from SOS Village Scheme to secure a further 3 months April – June 2016.

Dungannon The Agewell project is a partnership project covering the Mid Ulster Area including Cookstown, Magherafelt, and Dungannon. The aim of the project is to improve services for vulnerable older people in the community. Funded by the Big Lottery the project works with the local community providing a range of Free and Non Means Tested services including: o Good Morning Call: a free telephone care service for the over 50 and vulnerable five mornings a week, Monday to Friday to contact members for a social chat and to check on their wellbeing. o Home Maintenance Worker: 2 Home Maintenance Workers in place for the Agewell Project. The Home Maintenance Worker is available for Home visits to carry out security checks, small repairs or any other security checks, small repairs or any other household and gardening tasks. o Training: Within Agewell there are Multi Agency Training Sessions organised for all practitioners and Community Groups on Fuel Poverty, benefits, Home Safety, Crime Prevention and accessing local activities to enable them to provide consistent and up to date information for older people and making appropriate referrals. o Social Events: Events are organised to provide opportunities for older people to socialise. o Access to Benefits: The projects Community Development Coordinator and Community Link Worker are trained in carrying out Benefit Checks for vulnerable older people to increase uptake of benefits. o Fuel Poverty: Advise on how to access energy efficiency initiatives and benefits o Intergenerational Work; Bringing together older and younger people through ‘befriending’ projects, increasing awareness among young people of the needs of older people, giving opportunities to learn from each other and increasing mutual respect.

The Access & Information Service - a single point of access for receipt and management of referrals was established in 2012 to provide older people across the SHSCT area better access to information, skilled help, advice and support in relation to their Health and Social care Needs. The Access and Information Service sits within the Promoting Wellbeing Division of the Older People and Primary Care Directorate linking internally with staff/professionals and externally with community and voluntary providers around the development of a Directory of Services. The focus of Access & Information Service has been mainly in Integrated Care.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Services currently referred to through Access & Information:  Social Work in seven ICT’s.  Reablement in seven ICT’s.  Pilot Occupational Therapy in Armagh ICT – October 2015.  ICS referrals Step up and Step down Trust wide.  Central point for receipt of Regional Emergency Social Work referrals.  Plan to commence referrals to District Nursing from Acute and non-Acute from February 2016 (to be confirmed).

Benefits of Access & Information Service:  Enable Older People to regain their independence and exercise choice and control.  Standardised and streamlined processes for referral management and integrated care pathway (using the Trusts sub eligibility criteria).  Resource for Professionals, Staff, Service User, Families, and Carers (Holistic and Person Centred).  Assessments uploaded onto CIS (Paris) which will free up professionals time.  Signposting, redirecting and referral on to services within the Community and Voluntary Sector (enhanced partnership/integrated working/more efficient and effective).  On site Professional Staff support and advice at point of contact.

Development of a Trust Directory of Services to include Community and Voluntary contacts/services across the SHSCT area for service users, carers, staff and service providers to enhance accessibility and user friendly information.

Mind the Gap – Links in to the Good Day Good Carer service to share information with carers on upcoming events and training when available. Links to Mind the Gap Outreach support worker for the Southern Trust, to advise and signpost for services. Big Lottery funding extended for a further 2 years. Action 29: Traveller Action Improved ethnic Improved life Action Plan reviewed Gerard Rocks, Assistant Ongoing Local Group monitoring expectancy. annually and Director of Promoting Action databases. implemented. Wellbeing (acting) (SHSCT). Continue to Improved services to . Lower life coordinate Trust Targeted services. families & children. Progress report April expectancy, Traveller Action 2014. poor uptake of Group to address the Improved health Programmes for target

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) all services, key priorities status & equitable groups. low levels of identified within All access to services. literacy, lack Ireland Traveller Summary of PPI of targeted Health Study and Links with regional Impact developed. work for male emerging issues from PHA Traveller Travellers, local Traveller Health and families and communities in Wellbeing Forum. children. relation to health and social care. Source : All Ireland Traveller Health Study 2010 Action 29 – Notes of Attainment: Action Completed

This group which meets every quarter comprises representation from Travellers and local Traveller Support Groups together with key Trust staff across all programmes of care. Following a baseline mapping exercise to provide an overall picture of the approaches taken within each Directorate, an action plan was developed. Traveller Action Group Progress Report 14/15 was previously developed. An Action Plan for 15/16 was also developed see future plans below. Funding has been secured and a Health Trainer Coordinator to support Travellers and other disadvantaged communities to complete accredited and non-accredited training to increase employability commenced 20/4/15.

The Trust Traveller Action Plan focuses on 6 key areas: Policy and Culture, Information, Involvement, Service Provision, Volunteering and Employment.

2015/16 Update:

Traveller Action Group Progress Report 15/16 - key areas of progress include:

 Membership extended to include Toybox, Traveller Educational Support Service (TESS), NIHE, DEL and PHA.  The Trust appointed some new staff to provide additional services for Travellers: · Early Intervention Coordinator - To enhance coordination of family support programmes and referral pathways. · Public Health Nurse - Protected Traveller family caseload. Section 75 Action Based Plan - Appendix 2 – Page (73)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) · Health Training Coordinator - To develop an accredited training programme to provide Travellers with the opportunity to enhance their skills and knowledge and become qualified Health Champions and Health Trainers and increase employability options.  The Trust delivered Roots of Empathy programmes in 6 primary schools attended by Traveller Children  Safe and Well provided Traveller Cultural Awareness training to 8 staff teams (120 staff) on request  Traveller Support Workers completed training on Mental Health First Aid and ASIST and worked with AWARE NI to ensure that Travellers could attend training to support their mental health and emotional wellbeing.  Transforming Learning Communities (TLC) - Project was funded for six years (2009–2015) through the Big Lottery’s Live and Learn Programme to address educational barriers and inequalities for Irish Travellers and Migrant Workers. The SHSCT was a partner on this project. Over the last six years 101 courses were delivered to 616 Travellers.  Community Health Training - This programme was funded by PHA and managed by SHSCT. During 15/16 a total of 16 Travellers completed Community Health Champion and 1 completed Health Trainer accredited courses and wraparound support programmes. Funding has been extended for a further 2 years to embed and further develop the model.  Safe and Well - The Trust was also a partner on this Big Lottery funded project which ended in February 2016 and aimed to develop activities to enhance community cohesion and take an integrated approach to working in partnership between Travellers and service providers. Activities also added value by complementing the ongoing work of organisations that provide services to Travellers and by developing new activities where gaps in existing services were identified. A very successful celebration event attended by over 20 Travellers was held on 25th February to mark the end of the project and the achievements of all those who had participated.

The Hearty Lives Craigavon Project that aimed to improve heart health for Black Minority Ethnic (BME) and Irish Traveller Communities was funded for three years by the British Heart Foundation (BHF) and managed by the SHSCT. The Project commenced in January 2013 and ceased in March 2016. The outcomes of this project include: 1359 people had a Hearty Lives Craigavon health check in the community: 564 from the BME community, 84 from the Irish Travellers community, and 711people who do not fall within the two core target groups. The Project developed good working relationships with 8 workplaces. 464 people had a Hearty Lives Craigavon health check in the workplace. 110 people have been referred to their GP following the health check with an ‘at risk’ result; including abnormal blood sugar 18, high blood pressure 43 and high BMI 49. Some people were referred because they had two at-risk results. 120 people have sought follow-up health checks and on-going advice from the Project Coordinator. 256 people have engaged in programmes and workshops. 24 Traveller children attended a Heart Health workshop delivered by the Project Coordinator. 21 people have been assisted to register with GP. Programmes or workshops have been delivered to 9 community organisations. Total beneficiaries: 6441

An Action Plan for 16/17 is being developed.

Section 75 Action Based Plan - Appendix 2 – Page (74)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) Action 30: Hearty Lives Continue to Increased awareness Jan 15 Lynne Smart Ongoing Local Projects implement work of risks of CVD. Head of Health Action plan based on BHF monitoring and Improvement (SHSCT) Continued roll out of feedback from Increased access to progress reports. . Improved Hearty Lives stakeholder events. services. awareness of Craigavon Project risk factors of funded by BHF Reduced levels of CVD for £100k over 3 years in CVD in Traveller and Travellers and partnership with Migrant Workers in Migrant CBC, CTSC, CIP, Craigavon area. Workers and PHA, GPs and local improved employers. access to support services Action 30 – Notes of Attainment: Action Completed

There is a concerted need to address cause-specific issues for respiratory and cardiovascular disease. Hearty Lives Craigavon is a British Heart Foundation 3 year project located in and managed by SHSCT which commenced in January 2013. The aim of the project is to improve heart health in BME and Irish Traveller communities and to raise awareness of the causes of cardio vascular disease and the associated risk factors and to provide screening, information, resources and sign posting to local support services to facilitate early intervention for Traveller and BME communities in the Craigavon Area. Working in partnership with Craigavon Traveller Support Committee and other local BME support groups, this Project in now well under way. Jane Ferguson, a qualified Nurse employed as the Hearty Lives Health Co-ordinator, has worked closely with Craigavon Traveller Support Committee and after school, Polish Saturday School, Wah Hep, Splash Sure Start, Richmont Community Association and Community Intercultural Programme, local workplaces and many others to provide Heart Health screening, British Heart Foundation resources and health advice.

As at 2014/15:  488 individuals with a Black and Minority Ethnic background have received Cardiovascular Risk factor screening.  67 Irish Traveller have received Cardiovascular risk factor screening.

Section 75 Action Based Plan - Appendix 2 – Page (75)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)  22 BME individuals have been assisted to register with GP.  138 people have been trained in Heartstart.  Smoking cessation, walking and healthy eating sessions have been facilitated with children within these communities.

This raises individual awareness of risk factors for heart disease and encourages individuals to make lifestyle changes or access GP for treatment as appropriate. The project has also raised awareness of the need for GP registration and supported people unaware of how to register.

Brenda Toal (Programme Manager for Hearty Lives Craigavon) and Jane presented at the Business Services Organisation Conference ‘The Business Benefits of Equality, Diversity and Human Rights’ and their presentation was very favourably received by the audience. This was also reflected in the evaluation.

The success of the Project has been recognised both locally and nationally. Jane along with Lisa Hogg, CTSC, attended an awards ceremony hosted by the British Cardiovascular Society in Manchester (3rd June 2014) where the project was Highly Commended. Jane was also a finalist in Trust Excellence Award category for partnership working.

Consultation events to inform the final year of the project have commenced. All learning from the project will be evaluated internally and by an external evaluator to inform future planning of service provision in SHSCT as the SHSCT is committed to providing quality care for all.

2015/16 update:

The Hearty Lives Craigavon project ended on 31st March 2016 and there have been a total of 6441 project beneficiaries - further detail is given below.  642 BME individuals have had heart health screening  410 BME individuals attended lifestyle change programmes (Target = 180)  89 BME individuals were referred to GP for management of CVD risk factors  22 individuals have been assisted to register with a GP  120 Irish Travellers have attended lifestyle change programmes (Target = 30)  18 Irish Travellers referred to GP  7 GP Practices have BHF information racks  Heartstart has been delivered to 252 people in community settings

Section 75 Action Based Plan - Appendix 2 – Page (76)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)  181 Irish Travellers have had heart health screening (Target = 140). The project continues to showcase and share learning of the project and an evaluation report has been prepared by an independent evaluator. Jane has been shortlisted as a nominee for the Royal College of Nursing Nurse of the Year under the Public Health Category. Learning from the project has been shared with the Head of Health Visiting to inform development of the NI New Entrants Health Screening service that is being progressed for the southern area.

Action 31: REACH Programme Monitor targeted Greater opportunity for 2015 Lynne Smart Ongoing Local health improvement participation in Head of Health Action Continue programmes targeted health Monitoring Improvement (SHSCT) implementation and delivered under key improvement Arrangements . Obesity and development of headings: programmes. Annual Reporting poor health Regenerating . Family Weight 2011-15. choices by Environments and Management Evidence of improved Annual milestones those with Communities’ Health . Green Gym health and wellbeing. set against 5 Mental Health (REACH) programme . Community overarching project issues, to target groups. Lifestyle outcomes. disability and Community Health BME groups Provide training to Mentor Scheme. including support Health Travellers. Promotion Application for Extended opportunity Programmes that additional 1 year for participation in target Section 75 funding. targeted health Source: Consultation groups. improvement exercise in southern programmes. area - KPMG Increase awareness Management of health Consultants (2008) improvement and SHSCT Race Equality community Forum regeneration issues.

Creation of more Section 75 Action Based Plan - Appendix 2 – Page (77)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) opportunities for target groups to participate in health improvement and community regeneration programmes including Green Gym, community lifestyle programmes and Family Weight Management. Action 31 – Notes of Attainment: Action Completed

REACH Big Lottery Project

In 2010, a multi-agency partnership led by the Southern Health and Social Care Trust (SHSCT) was funded by the Big Lottery Fund Safe and Well Programme to deliver the REACH project (Regenerating Environments and Communities Health) across the Southern area. This 6 year funded project is now complete having finished at the end of February 2016.

The REACH Project aims to empower individuals, families and communities, faced with inequalities in health, to improve their health and wellbeing through interaction with, and improvement of their environment. REACH activities engage specific groups of people including: those living in disadvantaged areas; Black and Minority Ethnic (BME) communities; Travellers; people with disabilities and mental health problems and families and children at risk of obesity.

Key strands of activity within the REACH project have included as follows :

 Delivery of Community Lifestyle Programmes, including physical activity programmes that make use of the outdoor environment, to help promote physical and mental wellbeing  Family Weight Management Programmes

Section 75 Action Based Plan - Appendix 2 – Page (78)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)  REACH Green Gym –the Conservation Volunteers provide opportunities for people to enhance their fitness and health while taking action to improve the outdoor environment through grading and conservation sessions.  Training and supporting volunteers to act as Community Health Mentors.

2015/16 Update:

Over the last year 184 Green Gym sessions have been provided with 287 participants, resulting in 1683 Volunteer days. A partnership proposal has been developed with Armagh Council to build community groups use of a garden area within the council grounds at Palace Stables. NB: Traveller women play an important role in facilitating engagement with Traveller men by encouraging their involvement. Men’s health issues need to be addressed specifically - Traveller men are dying 15 years younger than their settled counterparts.

Over the last 6 years REACH has exceeded its targets with 460 lifestyle programmes delivered with 7700 participants, including greater use of the outdoors for walking and cycling. This highlights the success of the REACH team in engaging communities and harder to reach groups, including people in areas of deprivation, Travellers, BME communities, people with mental health needs and those with a physical disability or learning disabilities. Qualitative feedback from participants in the progarmmes evidences that programmes have enabled participants to make changes to their lifestyle in support of their health and wellbeing.

231 children and parents and 63 adults with a learning disability and carers have participated in Move it Change It weight management programmes. Evaluation shows that by the end of the 8 week programme the majority of those who attended had made positive changes to diet and lifestyle.

The community interest and participation in gardening activity has been increased with 163 community groups engaged in Green Gym sessions and over 1000 participants. 84 volunteers within communities have received training to build their skills in gardening activity and community groups have been supported to access further funds to continue their projects.

Recognising the need to build capacity within communities REACH has actively supported volunteering which has enabled 2200 people to engage in health and wellbeing activities. Many of these Volunteers were participants in REACH programmes and went on to volunteer within the project. 25 community volunteers have been trained as Community Health Champions (CHC’s), gaining OCN accreditation and supporting them to be an on-going resource for health within their community. CHCs have also been trained as facilitators for Cook It, walking, cycling and other activities for the benefit of their own communities.

Section 75 Action Based Plan - Appendix 2 – Page (79)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) REACH partners are now seeking to build and embed the learning from the delivery of REACH. Further CHC volunteer training has been offered through Neighbourhood Renewal projects to further build community capacity for health and wellbeing. The legacy of the REACH Initiative is to employ 3 part-time Band 3 Support Workers to support the Health Improvement Lead, Community Development and Delivery Programme and Community Health Champion. Action 32 LGBT Engagement Active targeting of Increased social Commenced March Lynne Smart, Head of Ongoing Local – Promoting anti-stigma training integration and 2011 and ongoing Health Improvement (acting) Action positive attitudes programmes advocacy for LGBT (rollover action to (SHSCT). towards Trust staff, groups in service new plan 2014-17). . Homonegative Continued community and planning and delivery. Monitoring attitudes and implementation of a voluntary Arrangements prevailing range of approaches organisations. Staff attitudes heterosexism to increase survey. in Northern engagement with Support for Evaluation/impact of Irish society, LGBT groups and development of training. together with reduce social stigma, Newry Rainbow Partnership the isolation isolation and related Community, development with that being negative health including training Rainbow non- impacts. and mentoring of Community. heterosexual Improve attitudes volunteers. Monitoring of may bring, towards the social volunteer play a major integration and training/support. part in wellbeing needs of the incidence LGB groups. of emotional and mental Reduce social health stigma, isolation and difficulties, related negative suicidal health impacts. ideation and self-harm in this (LGB) Section 75 Action Based Plan - Appendix 2 – Page (80)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) population.

Source: Rainbow Project, 2006 Action 32 – Notes of Attainment: Action Completed

The Public Health Agency (PHA) commission and fund training and support services for the LGB&T community in the SHSCT area. The Rainbow organisation is funded to provide a 6 week personal development course for individuals who identify as LGB&T within the Southern area. They are also funded to provide Befriending and Mentoring service for individuals and their families and to provide Training on Sexual Orientation and Gender Identity to a minimum of 20 staff within the Southern area. The PHA monitor this contract.

2015/16 Update:

The Promoting Wellbeing team continue to offer HIV Awareness Training which includes a focus on tackling stigma and discrimination and challenging perceptions about communities at risk of HIV. Action 33: Teenagers and Provision of Enhanced sexual Commenced March AD Learning Disability Ongoing Local Adults with guidelines and health and wellbeing, 2011 – ongoing Noreen McComiskey Action Learning Disability training for including reduced (rollover action to – Sexual Learning Disability stigma, for people with new plan 2014-17). . Teenagers Relationships staff and other a learning disability. and adults providers. Monitoring Lynne Smart, Head of with learning Provide a Arrangements Health Improvement (acting) disabilities consistency of Sexual Health (SHSCT). should have service provision Strategy Steering access to regarding sexual Group. information relationships for about sex, people with a sexuality and learning disability.

relationships. Enhance sexual health and wellbeing Source: FPA 2008 Section 75 Action Based Plan - Appendix 2 – Page (81)

2015/16 Update:

The PHA continues to fund the FPA to deliver a sexual health programme for young people with a learning disability called Just Ask. This programme is offered across the Trust area and the contract is monitored by the PHA.

Regional Personal Development guidelines for learning disability have been finalised and will be used by LD staff in the Trust to guide them in their support of people with a learning disability. Additional resources on puberty and sexual health issues have been purchased for staff to use in their discussion about sex and relationships.

The Trust LD teams continue to provide the SHAPE programme (Social Health And Personal Experience) across the Trust area. Learning disability team have facilitated training and work with youth clubs, parents and young people with a LD to support the safe integration of young people with a learning disability into mainstream youth settings. Action 34: Continued Roll out Fit4U Project Improved physical, Commence March Lynne Smart, Head of Ongoing Local of Fit4U Project Officer appointed mental and social 2011 and ongoing Health Improvement (acting) Action and working across health. (rollover action to (SHSCT). Fit4U Project seeks SHSCT area, new plan 2014-17). . Lower to empower people developing More people participation with physical / accessible physical participating in Monitoring rate in sensory disabilities to activity physical activities and Arrangements physical improve their health opportunities for sports. Access rates, activity among through participation adults with qualitative surveys, adults with in a range of physical physical/sensory Strategic and focus groups. disabilities. activity and leisure disabilities in local Operational . Participation opportunities, which leisure centres. Partnerships rates for promote developed. disabled independence and

Section 75 Action Based Plan - Appendix 2 – Page (82)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups) people are citizenship. Weekly physical around half of activities across the adult SHSSCT area. population as a whole. Leisure services staff, . In 2005/06 coaches, carers and 13% disabled volunteers trained in adults relevant disability participated in training. the last week, compared to 29% for adult population as a whole.

Source: NISRA – Continuous Household Survey, Adult Sports Participation Survey Action 34 – Notes of Attainment: Action Completed

Fit4U Project primarily seeks to empower people with physical/sensory disabilities to improve their health through participation in a range of physical activity and leisure opportunities, which promote independence and citizenship. Fit4U clubs have been established in all 4 Trust areas – Newry & Mourne, Craigavon & Banbridge, Armagh and Dungannon. The SHSCT provides non-recurrent grant covering all 4 areas.

Fit4U clubs are user led and responsive to members’ needs. Support continues to be provided to a range of strategic area wide programmes and projects that deliver community based physical activity programmes including Fit4U.

The Fit4U programme continues to facilitate access to physical activity opportunities for people

Section 75 Action Based Plan - Appendix 2 – Page (83)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact (For Output Arrangements S75 Groups)

2015/16 Update:

Oct to Dec 2015 . 12 Structured Programmes . 10 monthly inclusive sports competitions. . Participated in 2 Council Boccia competitions. . 56 activity sessions provided. . 155 individuals involved. . Across 56 sessions - Total Participation 756 July to Sept 2015 . 6 Structured Programmes . 4 monthly inclusive sports competitions. . Participated in 2 Council Boccia competitions. . 25 activity sessions provided. . 133 individuals involved. . Across 25 sessions - Total Participation 392 April – June 2015 . 1 Southern Area Event – 2 Fit 4 U Clubs participated in Get Active Day - May 2015. . 13 Structured Programmes . 12 monthly inclusive sports competitions. . Participated in 3 Council Boccia competitions. . Participated in 3 Council Kurling competitions. . 56 activity sessions provided. . 102 individuals involved. . Across 56 sessions – Total Participation 572

The SHSCT has been funded recurrently by the LCG to take forward Fit 4 You for people with a learning disability and has commenced planning in relation to this. A 10 week pilot programme has been offered in the Armagh area with 11 participants.

Section 75 Action Based Plan - Appendix 2 – Page (84)

SECTION 3

EMPLOYMENT

Measures to promote participation, equality of opportunity and good relations in the workplace Pages 88 - 112

Section 75 Action Based Plan - Appendix 2 – Page (85)

SECTION 3 – EMPLOYMENT RELATED ISSUES

Measures to promote participation, equality of opportunity and good relations in the workplace

Introduction

This section of the Trust’s Equality Scheme Action Based Plan has been developed in recognition of the following context as it relates to employment equality within the Trust:

 The Trust has already in place a range of Employment Equality and Human Resource Policies which have been developed in consultation and in partnership with a range of key stakeholders and Trade Unions. These Policies are reviewed as a matter of course on a 3 yearly basis but earlier if there is a need to take account of legislative and case law developments. These Policies are subjected to Section 75 screening to ensure the promotion of equality of opportunity and good relations across the nine equality groups, to highlight and address multiple identity issues and the avoidance of discrimination. Employment Policy is benchmarked against the Equality Commission for NI’s Employment Codes of Practice and Best Practice Guidelines. The Trust will continue to monitor and publish screening outcomes on the implementation of these policies as part of its commitments in its Equality Scheme.

 Further, the Trust provides a comprehensive menu of Equality Training. This includes corporate induction training for all newly appointed staff; equality training for managers which includes specific training on Working Well Together and Harassment; E-Learning online Discovering Diversity training for staff which includes specific training on Disability Awareness and Good Relations e.g. Customer Care. Further training is provided for policy authors and decision makers as it relates to S75 equality duties and Human Rights. In addition Working Well with Interpreters training is provided to frontline staff to ensure the effective use of the interpreting provision. A specific aspect of this Plan i.e. Action 36 is to increase the provision of equality training and monitor and evaluate its effectiveness.

 The Trust has in place a Working Well Together Policy and Harassment At Work Procedure which detail the support in place to ensure appropriate and confidential facilities to enable individuals or groups facing Section 75 Action Based Plan - Appendix 2 – Page (86)

discrimination to raise their concerns. Further, the Trust has a Disciplinary Procedure with clear and explicit measures, remedies and sanctions for acts of discrimination, harassment and unacceptable behaviour at work. Through its Health and Wellbeing Strategy and associated Action Plan, collaborative working with Health Improvement, Health and Safety, Education, Learning and Development, Occupational Health and Absence Management Teams, in partnership with Trade Unions and relevant others the Trust is involved in a programme of work to improve the working lives of staff and provides appropriate support, guidance and advice on a range of issues.

 The Trust undertakes a systematic audit of its workforce composition as part of its statutory annual and three yearly monitoring requirements under Fair Employment and Treatment (NI) Order 1998. The Trust has just recently completed its second Article 55 Review Report which includes a comprehensive analysis of existing workforce composition, workforce flows, leavers, employment policy and practice. HSC Trusts are working in partnership with the ECNI and a range of relevant stakeholders as part of an agreed multi-dimensional approach to address current employment trends within health specific occupations. In addition, HSC Trusts will continue to work with the ECNI and TUs with regard to local labour force issues. See below action measures arising from the review to be taken forward in this the Trust’s second Action Based Plan which are aimed at promoting fair participation in the workplace. Of note, the Introduction of a new information system for both Payroll and Human Resources will ensure that equality data for current staff is accurate and as up-to-date as possible as it will be facilitated by Employee Self Service – which gives staff direct access to update their own equality data. The Trust will continue to utilise this data when drafting and reviewing employment policy and to inform on-going equality screening and EQIAs.

 The Trust has also established a local implementation team with representatives from service and functional areas within the Trust along with the disability sector to take forward the actions in its revised Disability Action Plan, including actions to increase the participation of disabled people in public life and to promote positive attitudes toward disabled people as set out in its Policy on the Employment of People with Disabilities and related information sources.

 There follows a series of actions as they relate to employment equality for the incoming plan and 3 year period 2014-17:

Section 75 Action Based Plan - Appendix 2 – Page (87)

Section 3 – Employment Measures to promote participation, equality of opportunity and good relations in the workplace

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Action 35: Gender Equality To gain a greater Improved career Year 1 HSC Equality Leads, Senior New Regional insight to the pathways for men Managers in HSC Care in Action Survey aimed at barriers/impediment and women in Production of partnership with UUJ and investigating a s that impact on an securing senior Research Report and ECNI – in terms of roll out of

number of gender individual’s career management Associated any forthcoming  University of equality issues at aspirations and positions within the Recommendations recommendations Ulster executive/senior progression to a public sector. which will feed into the Jordanstown managerial levels senior position with lifespan of the current (UUJ) Survey which may affect an the public sector. Plan 2014/2017. of: Male and individual’s career Female aspirations to reach Employee a senior position Views of within the public Gender sector. Equality at Executive/ NB: The work is Senior being conducted by Managerial the UUJ on behalf of levels in the NI OFMDFM and in co- Public Sector. operation with the Public Sector. Source : OFMDFM Funded Research Project in partnership with UUJ – Research

Section 75 Action Based Plan - Appendix 2 – Page (88)

The research, which was funded by OFMDFM, is concerned with investigating Gender Equality at Executive/Senior levels within the NI public sector which may affect an individual’s career aspirations to reach a senior position within the public sector.

2015/16 Update:

The Report findings have since been launched at an event at the long gallery, Stormont Buildings on 24th March 2016 where a presentation was given by Professor Joan Ballantine, UUJ. Representatives from both the Belfast and Southern Trust were in attendance. The following recommendations were noted:

 The achievement of equal participation of women and men (i.e. a minimum of 40% from either gender) on executive management boards by January 2021.  Organisations should identify a Gender Champion (either male or female) employed at the most senior level of management.  Establish an Academy for developing professional executives/managers across the public sector.  Establish a Public Sector Forum for Gender Equality as a conduit for the sharing of experiences, problems, potential solutions and best practice.  Establish an overarching Public Sector Women’s Network for current and aspiring executives across the public sector.  Develop a gender inclusive culture at senior management levels which promotes the acceptance and use of flexible working arrangements.  Develop a culture which promotes an appropriate work life balance.  Ensure career development opportunities are allocated in a fair, transparent and competitive manner  Deliver mentoring opportunities in an open, fair and consistent manner  Link performance management more clearly to career development  The Equality and Strategy Directorate, OFMDFM, should collect robust and comparable data and publish an annual report  Data should be collected at an individual organizational or sector basis regarding barriers to achieving gender equality at senior management levels.

Of interest the research findings highlighted that women fair better where there is a female Chair and CE at the head of public sector bodies. The Trusts have examined the recommendations to see what further steps can be taken to further ensure gender equality in the workplace and will take these recommendations on board in developing their respective Equality Scheme Action Based Plans for the period 2017-2020/22.

Section 75 Action Based Plan - Appendix 2 – Page (89)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) The Trust has an expanding range of initiatives in place such as Work Life Balance schemes to enable employees to reconcile competing demands/commitments, succession planning programmes aimed at growing potential, and various other leadership and professional development courses to develop the potential of future managers. Action 36: Tackling Racism, Continue to Improved uptake of 2014-2017 Equality Lead, Employee Ongoing Local Sectarianism and increase provision training and the Relations, Management and Action other types of hate of training for all promotion of Over 3 year period. Trade Unions . Potential crime staff, specific positive attitudes issues re. training for on the part of staff Monitoring Racism and Continue to raise managers and and managers Arrangements: Sectarianism awareness amongst promotion of e- toward all S75 Training evaluation in the staff of racism and learning - groups. and regional staff Workplace. sectarianism and Discovering survey results. other types of Hate Diversity training. Increase Source: Racist & Crime. awareness of Trust sectarian attitudes. Ensure Induction Equal Opportunity PSNI stats on Continue to review, training includes Policies and Sectarian & Hate develop and support cultural diversity procedures e.g. Incidents & Crimes workplace initiatives training. Working Well during 2009/10 to promote respect Together Policy increased by 15.4 % (245) & racial by 4.8% and cultural diversity. Ensure and Harassment (48) in comparison to Management Procedure along 2008/09 Continued roll out of Development with the promotion training on equality programme of Health and Programme for and diversity and includes Wellbeing initiatives Cohesion, Sharing & evaluation of responsibilities of to promote staff Integration – effectiveness of on managers. welfare. OFMDFM. line equality training. Zero Tolerance of Reduce levels of Abuse of HSC Staff harassment (DHSSPS)/Trust complaints and Policy Embracing equality related Section 75 Action Based Plan - Appendix 2 – Page (90)

Source: Embracing Diversity Good Practice Guide for H&SC Employers (DHSSPS)

Source: HSC Complaints Action 36 – Notes of Attainment: Action Completed

The Trust’s commitment to promoting a harmonious working environment is set out in its umbrella Policy i.e. its Equal Opportunity Policy statement. Point 6.3 specifically states the Trust’s commitment to promote a supportive and harmonious working environment free from material or behaviour likely to be offensive, provocative or intimidating, or in any way likely to cause apprehension to any employee. In accordance with this principle, the Trust’s Harassment at Work Procedure and Joint Declaration of Protection, reflecting the Equality Commission’s guidelines on promoting a harmonious working environment, have been drawn up and agreed with the Trade Unions and Staff Organisations and drawn to the attention of staff. The Equality Commission was also consulted in the formulation of this policy. This commitment is further underpinned in the Trust’s Guidance on Promoting a Good and Harmonious Working Environment and Working Well Together Policy.

2015/16 Update:

The Trust provides ongoing equality training for its staff including corporate induction which includes the Trust’s duty to promote a welcoming environment; management development training for all managers with a specific module on equality and promoting positive relationships at work, as well as ongoing Discovering Diversity training for staff which covers all forms of discrimination including unacceptable behaviour in the workplace. The Trust continues to roll out training on equality and diversity and conducts ongoing evaluation of the effectiveness of its training provision. For further detail see point 24 of this year’s S75 Annual Progress Report. Section 75 Action Based Plan - Appendix 2 – Page (91)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Traveller Information Leaflet for Staff - Promoting Good Relations. In furtherance of the Trust's equality and good relations duties a staff information leaflet has been drawn up to celebrate and aid understanding of the Traveller community and culture. This resource is available on the Trust's intranet.

The Southern Trust’s Harassment Procedure was also updated during the year under review March 2016. Action 37: Supporting LGB&T Promotion of the Increased profile of Year 1 – 3 On-going HSC Trust Equality Leads, Ongoing – Staff Forum Staff Forum through and attendance at PHA and Rainbow Regional Action display of Posters Staff Forum. Monitored through To continue to and Information on S75 Annual Progress . Tackle support the Health Trust Intranet, Increased staff Report, training prejudicial and Social Care Wards and Facility awareness and feedback and service attitudes LGB&T Staff Forum. Notice Boards. good practice user feedback. and adopted. behaviour To develop training Training towards and awareness programmes for Increased staff LGB&T raising sessions for staff working with understanding of individuals. staff with regard to clients in residential issues faced and LGB&T Adults in homes. promotion of . Promote residential homes. inclusive culture. positive Multiple identity attitudes To raise awareness issues incorporated Increased towards of issues facing into equality and understanding of LGB&T. LGB&T with multiple diversity training. appropriate identities and tackle terminology and . Raise barriers experiences. Workshops barriers awareness organised and experienced. of the rights To work with PHA to regionally of LGB&T. Promote Training advertised. Raised awareness workshops for among staff of Healthcare Training seminar issues affecting Promoting Sexual Professionals. held on the needs lesbian women Section 75 Action Based Plan - Appendix 2 – Page (92)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Orientation of lesbian women accessing Equality To develop a with regard to maternity services. ECNI October 2013 Training Seminar to accessing maternity address the needs of and fertility Lesbian, Gay, lesbian women with services. Bisexual or regard to access to Transgender Planning for maternity and fertility Later Life services. AGE UK July 2013

Older People in Care Homes: Sex, Sexuality and Intimate Relationships RCN 2011 Action 37 – Notes of Attainment: Action Completed

The Discovering Diversity E-Learning platform has been augmented with an additional module on LGBT. This latest module was developed by the Public Health Agency in partnership with the LGB&T sector bringing the total modules to 7. The Trust continues to monitor the staff uptake – see the Training section (point 24) of this year’s S75 Annual Progress Report for further details of training – staff uptake 1,741.

The Trust continues to support the Regional LGB&T Forum in the interest of promoting inclusive workplaces and in furthering its equality and good relations duties. During the year under review the LGB&T Staff Forum provided stands in CAH and DHH to coincide with the week of Newry Pride 2015. The stalls which were supported by the Trade Unions provided information leaflets, flyers and lanyards publicising the HSC Staff Forum. The Chair of the LGB&T Staff Forum also presented at the annual Equality Conference which was held on Friday 27th February 2015. The LGB&T Staff Forum continues to meet quarterly and ongoing communication on issues relating to LGB&T are included on the dedicated website for staff www.lgbtstaff.hscni.net.

HSC organisations have agreed to progress toward LGB&T ‘I am an Ally!’ Diversity Champions status in partnership with Public Health Agency and other HSC organisations and The Rainbow Project. This initiative was discussed and agreed at a regional wide Diversity Workshop.

Section 75 Action Based Plan - Appendix 2 – Page (93)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) 2015/16 Update:

The Forum received a great response at its Craigavon hospital information stall. A stall was also organised at Daisy Hill canteen on Friday 21st August 2015 and was well support by staff. In addition, Newry Pride received a lot of support from staff on Trust facebook and Twitter feed.

Included amongst the wider festival events was an Information and Health Fair which took place on Thursday 20th August 2015 coordinated by The Rainbow Project, the Newry Rainbow Community and Newry Mourne & Down District Council with many locally-based organisations present to give information and advice on a wide range of health and wellbeing issues including, promoting positive mental health, the prevention of self- harm and suicide, cancer awareness, healthy eating, quitting smoking and many more topics.

A confidential sexual health testing service was available in the NRC Centre.

Forum members have also been promoting the elearning module www.lgbtelearning.hscni.net which counts towards KSF and professional registration.

The Forum is endorsed by all of the trade unions and Trust management with admin support from the Public Health Agency. Action 38: Increase in Increase in Enables disabled Monitoring Employment Equality Lead, Ongoing Local employment and employment of people to become Arrangements – Trade Unions, Action involvement of marginalised economically and Trust’s HRPTS Service Managers, Disability  Under marginalised groups (disabled socially active in System sector. representation groups (persons persons). the workplace and of people with with a disability) in the community.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) disabilities employed in Continued Make available a Promote the Trust (1.8% Implementation of minimum of 20 participation and self-declaring the Trust’s Disability work placements involvement of that they have Action Plan and year on year over persons with a a disability). Regional Framework the lifespan of the disability. on the Employment current plan  Employment of Persons with a December 2014 - rate of those Disability. onwards. without disabilities Increase in Continue to build (79%) is over employment of upon links with twice that of marginalised groups Disabled people with (disabled persons) Employment disabilities on a number of levels Service (DES) and (32%). e.g. volunteering, Disability sector. work placements, Source: Statement of substantive Key Inequalities in NI employment etc. (ECNI 2007). Ensure existing Employment employees who are inequalities in an or who become Economic Downturn ECNI 2010 disabled are supported and Greater staff Source: Trust’s facilitated through the awareness. Disability Action Trust’s reasonable Plans (DDA 1995 as adjustment amended) arrangements and, Take forward action where appropriate, arising from the Source: Analysis of conditions Forum. Section 75 Action Based Plan - Appendix 2 – Page (95)

Continue to facilitate Promote Forum to convene 2-3 Equality Assurance Unit and and support the participation and times yearly. Forum Members, Trade Trust’s Disability involvement of Unions and Disability Sector Forum the purpose of employees and which is to shape Promote a culture persons with a and influence Trust that empowers and disability. policy and practice supports disabled with regard to employees in the employment of workplace. people with disabilities and to address issues raised by the Forum.

Produce an Promotes and Twice yearly. information news facilitates positive sheet – highlighting attitudes towards case studies and employees and good practice in person with a order to promote a disability. culture that involves and supports employees with a disability. Section 75 Action Based Plan - Appendix 2 – Page (96)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)

Access support and Promotion of advice set out in the Reasonable ECNI’s Employability Adjustment Toolkit in relation to Guidelines for employability Managers. Ensure initiatives for persons appropriate with a disability. assessments are carried out, Ensure the fair provision of tailored application of induction. Recruitment and Selection Processes to promote the participation of people with a disability. R&S Panels to ensure reasonable adjustments are considered in a timely manner and that RAs are put in place and considered at interview. Keep under review the need for further reasonable adjustments for new and existing employees. Section 75 Action Based Plan - Appendix 2 – Page (97)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)

Ensure disabled staff are aware of flexible working options available in the Trust that may assist them to manage their disability. Review induction Appropriate use of processes for designated parking employees with a for people with a disability. disability.

Ensure staff and managers are aware of physical accessibility issues and that it is unacceptable to park in designated space – continue to monitor the usage of same. Action 38 – Notes of Attainment: Action Completed

2015/16 Update:

The Trust continues to implement its Disability Action Plan (DAP) in partnership with the disability sector – see Part B of the Annual Progress Report for a review of progress to date in relation to the Trust’s DAP.

The Trust values all its employees and seeks to ensure the continued employment of any employee who acquires a disability during the course of their employment with the Trust. The Trust’s Reasonable Adjustment Guidelines for Managers provides advice to managers on the reasonable Section 75 Action Based Plan - Appendix 2 – Page (98)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) adjustment duty; the importance attached to timely intervention(s) and on-going review/support. The Trust’s Recruitment and Selection Procedures were also reviewed having taken into account recent case law James Byrne v BSO amendments were made to the application form in relation to sickness absence recording - in the interest of upholding best practice. In this case the individual had taken issue that the application form required him to disclose information on his sickness absence (which was disability related) and he believed this disclosure compromised his position before the interview panel as he felt the information should have been dealt with separately. He believed the disclosure of this at the application stage was potentially prejudicial.

The case was settled through the LRA but one of the conditions of the settlement was that the respondent should liaise with the Commission in relation to the re-consideration of the construction and wording of the regional HSC job application form and that such reconsideration of the form would include representatives from the other Health and Social Care employers in Northern Ireland with the responsibility for Human Resources and specifically the regional application form. This has been addressed during the current reporting period. Linked to this same case the Equality Commission were also keen that the wording relating to Disability be removed from the application form and that this be dealt with as a separate issue and at the relevant point in the process i.e. conditional offer stage. This has also been addressed.

Trust’s Local Disability Forum - Promoting Positive Attitudes. The Newsletter has been produced as a result of the Trust’s Disability Action Plan, the aim of which is to promote positive attitudes towards disabled people and encourage the participation of disabled people in Public Life. The Newsletter provides an overview of the Trust’s disability related Policies and Practices available to support both management and staff in the workplace; as well as providing an overview of the disability legislation as it relates to employment policy and practice and current case law. Further, it provides a personal insight into the working lives of staff members who have a disability and how the Trust has catered for their needs in terms of reasonable adjustments.

A futher development includes the commitment to establish a Regional Disability Forum. The Human Resources Directors’ Forum gave their approval to the establishment of a Regional HSC Disability Staff Forum and, whilst supportive of this initiative, they were also keen that any regional forum would complement and augment local fora arrangements. Following an initial scoping to establish the extent to which local disability forums exist across HSC organisations a terms of reference was drafted for a Regional HSC Disability Strategic Steering Group whose remit it would be to:  Gather and share information of good practice to local networks;  Coordinate any agreed regional initiatives or work, such as conferences or awareness events; and  Develop and evolve as deemed necessary and appropriate by local networks.

Trust's Placement Policy - Promoting Participation. The Trust's Placement Policy continues to act as a bridge to gaining work experience in order Section 75 Action Based Plan - Appendix 2 – Page (99)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) to equip persons including those with a disability for future paid employment within the Trust and elsewhere. The Trust's Placement Policy stands alongside the Trust's volunteering scheme which also caters for persons with disabilities by providing meaningful volunteering opportunities for those with or without a disability. In addition, the Trust also receives referrals directly from local schools and colleges.

During the year 2015/16 the Trust faciliated 7 placements for persons with a disability. The Trust's Placement Policy stands alongside the Trust's volunteering scheme which also caters for persons with disabilities by providing meaningful volunteering opportunities for those with or without a disability. In addition, the Trust also receives referrals directly from local schools and colleges.

Previously HSC Trusts hosted a Disability Action Plan Workshop entitled: Public Appointments – Why Not You? on 30th September 2014. The workshop took place in the Glass House on the Stormont Estate. Over 40 participants were in attendance from across the disability sector, including representatives from the Equality Commission for NI. Now that links have been established, further work is planned with DHSSPS and the Disability Sector to endeavor to make the public appointments as user friendly as possible working within existing legislative paramenters with the aim of increasing the number of disabled persons in public life positions.

Action 39: Promotion of ECNI Implementation of Improved Year 1 and on-going. Trust Race Forum and Wade New Local Action Employment Tool positive action opportunities for Training. Kit – to enhance strategies to BME communities.  Barriers to employment increase the employment opportunities for participation of Improved experienced marginalized BME communities integration and by BME groups on placement, social cohesion. groups. volunteering and Removing barriers to employment within Source: ECNI employment and the Trust. Statement on Key improving access for inequalities in NI BME communities. Employment Continue to Inequalities in an implement Economic Downturn employability ECNI 2010 initiatives and utilise Section 75 Action Based Plan - Appendix 2 – Page (100)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) the ECNI Employability Toolkit to reduce health and social inequalities issues e.g. poverty, long-term unemployment. Action 39 – Notes of Attainment: Action Completed

Arising out of the CAWT Social Inclusion project the Trust provided 12-week work placements for 2 Travellers who had recently completed an Employment and Skills Training & Train the Trainer course, OCN Level 2 & 3. The placements were funded through the CAWT Social Inclusion Project.

Cooperation and Working Together (CAWT) is a partnership between the Republic of Ireland’s Health Service Executive Dublin North East and West areas, the Northern Ireland’s Western and Southern Health and Social Care Trusts, the Health and Social Care Board and the Public Health Agency. CAWT’s aim is to facilitate the partner organisations to work collaboratively in order to achieve the best possible health and social care outcomes for the population of the border area. The CAWT Social Inclusion programme was one of 12 projects supported through the European Union’s INTERREG IVA programme.

The Traveller strand of this project was established to improve social inclusion and demonstrate health and social gain by establishing a 40-week training programme for 20 Travellers. Upon completion of the training programme the Traveller participants were able to avail of paid work placements to enhance their job opportunities and to build on the skills they have developed.

The Southern Trust through its Traveller Action Group secured funding from the Public Health Agency to employ a Health Training Coordinator for 1 year to develop an accredited training programme to provide Travellers with the opportunity to enhance their skills and knowledge and become qualified Health Champions and Health Trainers and increase employability options. The programme will consist of 2 options: (i) Volunteer opportunities - Health Champion (Accredited at L2) with additional PWB and other support training as required providing:  A firm grounding to become involved in raising awareness of and signposting health improvement initiatives in their community, workplace or voluntary organisation.  Knowledge and understanding of the benefits of good health and wellbeing, and of the barriers to making a change of lifestyle. (ii) Employment opportunities - Health Trainer (Accredited L3) with additional PWB and other support training as required providing: Section 75 Action Based Plan - Appendix 2 – Page (101)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups)  Knowledge, understanding and skills required to deliver Health Champion training and health improvement initiatives in their community, workplace or voluntary organisation and enable individuals to change their behaviour to improve their health and wellbeing.

Volunteering

The Southern Trust has a Volunteer Policy and Procedures in place which have recently been reviewed. While there is 1 Traveller volunteer community health mentor active under REACH Project, the requirement for occupational health checks is a barrier for some Travellers who prefer to register and volunteer with their local Traveller Support Groups.

2 Travellers were supported to begin the volunteering application process and 2 volunteered throughout the summer programmes with the Armagh Traveller Support Group. 4 Travellers are now fully supported and trained to deliver cultural awareness training with Safe and Well staff.

Within the Craigavon Traveller Support Committee 1 individual was supported to begin the volunteering application process and 2 individuals volunteered throughout the summer programmes.

In Newry and Mourne, 1 Traveller completed 1 day of the of the 2-day accredited Health Champions training course and is now volunteering in Community Restorative Justice.

In addition, the Craigavon Traveller Support Committee have supported:  5 young people to access vocational training.  3 remain in their chosen course at this time.  4 adults have completed 9 sessions of literacy programme  4 young people completed Driving Theory programme  4 young people have completed and Introduction to ICT  14 individuals have been supported in job search. 2015/16 update: Currently 1 Traveller volunteer from Armagh is working with Safe and Well delivering Cultural Awareness Training 1 Traveller from Coalisland volunteering in homework club and enrolled in CTS for childcare course as part of volunteering opportunity. 16 Travellers trained as Community Health Champions (8 Dungannon, 7 Newry and 1 Craigavon).

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Action 40: Fair Employment Fair Participation in Both main 2014-2017 Employment Equality Leads, Ongoing Regional and Treatment (NI) the workplace. communities in NI Trade Unions, ECNI and and Local Action Order 1998 are fairly other relevant stakeholders Participate in multi- represented in the  Lack of fair Completion of Article dimensional workplace. participation in 55 Review Report in approach in the workplace. line with Fair partnership with the Employment and ECNI and relevant Source: Fair Treatment (NI) Order stakeholders to Employment A 1998. address current Generation On (ECNI) employment trends across all 5 HSC Source: Statement of Trusts as it relates Key Inequalities in NI to health specific (ECNI 2007).

occupations.

 Promotion of HSC Trusts to fair continue to work participation in with the ECNI and the workplace. TUs in addressing

Source: Article 55 any localised labour Review Reports force issues. (ECNI)

ECNI Annual Fair Employment Monitoring Report No 23

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2015/16 Update:

2nd Article 55 Review reports have been completed by all HSC Trusts showing workforce composition, employment trends, recruitment flows and appointments together with leavers. The Equality Commission for NI has since met with employment equality leads to discuss the findings from their respective reviews. Each Trust is to take forward actions as they relate to their local workforce. In addition, the Equality Commission agreed to undertake further research as regards emerging trends from University re health specific occupations (i.e. professional occupations) in partnership with local universities and will discuss their findings with HSC Trusts.

The purpose of the Article 55 Review is to enable the Trust to determine whether or not Protestants and Roman Catholics are enjoying, and are likely to continue to enjoy, fair participation in the organisation. The Trust is mindful that fair participation must be considered at the level of the individual employer and workplace location and recognises that a fuller understanding of apparent sectoral patterns will only come as part of the completion of its triennial review. The review helps to identify appropriate and practical affirmative action programmes, to ensure the achievement of equality of opportunity and fair participation. Where it is practicable to do so, the Trust is required to set goals and timetables as a means of measuring change and assessing the effectiveness of any affirmative action measures put in place.

Trust Equality Managers each met with representatives from the ECNI during the current reporting period to consider their assessments of fair participation emanating from their 2nd Article 55 Review report. The ECNI undertook to review the Trusts completed assessments of fair participation (against the 2011 Census figures) and to report back its findings to the Trusts. The Trusts have also considered the Commission’s owned assessment of fair participation against the 2001 Census and have responded to this assessment accordingly with a subsequent analysis that takes into account local factors and the positioning of services. The ECNI has indicated that it would like to meet with Trust Equality Managers in preparation for their 3rd Article 55 Review. Trusts look forward to these forthcoming meetings the purpose of which is to mutually agree the extent of fair participation and areas of under representation as a base line in moving forward.

Of note the Commission recognises that the position with regard to health specific occupations is complex with Health Trusts recruiting employees who have already, in the main, been trained in the relevant health disciplines, for example nurses, doctors, social workers and other related occupations. As noted in the Commission’s own composite report, released in May 2012, much of the recruitment at this level is at a regional rather than at Trust level and therefore the control which individual Trusts have over the composition of employees recruited is limited. For these employment positions the need for a multi-dimensional approach has been recognised, with the Trusts working together with other partners, including the Commission, to develop and take forward a strategy to ensure that all communities in Northern Ireland are aware of and Section 75 Action Based Plan - Appendix 2 – Page (104)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) are encouraged to work in health related professions. Such partners may include the Department of Health, Social Services and Public Safety as well as the various professional and regulatory organisations which impact on the recruitment and employment of health care staff in Northern Ireland. As stated above the Commission have however indicated a need to conduct further research into the current trends with local Universities re health specific occupations (i.e. professional occupations) to inform the way forward.

The Trusts looks forward to playing their part in this multi-dimensional approach and engaging further with the Commission and key stakeholders as regard health specific occupations. This multi-dimensional approach does not replace the ongoing discussions the Trust has had to date and will continue to have with the Commission regarding the particularities of its own localised labour force and employment situation. HSC Trusts are currently engaged in overseas recruitment of nursing staff and are working collaboratively in developing an informed induction programme to ensure the integration of these staff into the new environment. Action 41: Young Persons Increase in number Young people 2014-2017 Liz Stevenson, Head of Long Ongoing Local leaving care of care leavers leaving care are Term Residential Care, Action aged 19 are in socially integrated Monitoring Leaving To enhance access education or and economically Arrangements - Care and After Care Services Poor outcomes for to employment, training in order that active. Over 3 year period. (SHSCT). care leavers in training and they are better Monitoring and (Supported by Learning and education, training education prepared for evaluation of Development Manager) and employment. opportunities for transition to effectiveness of (SHSCT). young persons adulthood and initiatives as a The Health and leaving care. independence. Priorities for Action Social Care . target. (Commissioning Increase by 50% Plan) Direction the proportion of Progress monitored (Northern Ireland) care leavers in and reported via the 2013 education, training Trust’s S75 Annual Target 26: By March or employment at Progress Report to 2014, increase the age 19. the ECNI. number of care leavers aged 19 in education,

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Source: Priorities for Action Action 41 – Notes of Attainment: Action Completed

Young Persons in Transition from Care - Employability Project - Promoting Participation

The Trust has made significant investment in supporting the education, training and employment needs of Looked After Children. This has been achieved through the introduction of an Employability Project which aims to provide young people with the 16Plus Leaving and Aftercare Service with support to enter and sustain education, training and employment opportuntiies within the Southern Trust locality.

2015/16 Update:

Currently as of April 2015 - 87% of young people aged 19 leaving care are in Education, Training or Employment within the Southern Trust. Action 42: Development of a Provides for a Policy which Year 1 Business Services New Regional Regional consistent promotes best Organisation in partnership Action Recruitment Policy approach to the practice across the with HSC Recruitment and for the management management of an HSC sector and Equality Leads . Need for a of regional increasing trend provide for consistent recruitment toward regional consistency in approach for exercises recruitment across approach together regional the HSC sector. with a more recruitment effective use of Section 75 Action Based Plan - Appendix 2 – Page (106)

Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Source: ECNI Unified resources. Code of Practice on Employment Action 42 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

2015/16 Update:

HSC Trusts continue to operate under their own Recruitment Policies which have been recently reviewed. The BSO are progressing work on a regional policy – work is still on-going. It is anticipated that a regional policy will be in place by March 2017. Action 43: Development of a To promote an Policy which Year 1 Business Services New Regional Regional inclusive workplace promotes best Organisation and Equality Action Transgender Policy where: practices across Leads the HSC sector. . Promotion of Transgender inclusive people feel workplace comfortable to express their Source: Sex gender identity; Discrimination (Gender Transgender people Reassignment) can fulfil their full Regulations (NI) 1999 potential and fully contribute to the workplace;

All staff made aware that discrimination against transgender people (whether by

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) staff or third parties) is not tolerated and any allegations thereof are dealt with in an effective manner. Action 43 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

A first meeting to discuss the development of a Transgender Policy was held on Thursday 8th May 2014 in the Business Services Organisation. This first meeting was very productive. Areas requiring legal clarity included: scope of protection and records management/disclosure. BSO agreed to engage with legal services on the following issues: absence management and handling of information records.

General agreement was reached that the policy should be short and that protocols for managers, staff and HR are to be produced separately to underpin/assist with the roll out of the policy in the workplace. Training materials are also to be produced. Timeline for key activities and consultation produced following first meeting. It was agreed that the development of the policy will be progressed in the following steps: network (operational level), finalise 1st draft, engage with trans sector and trade unions, 2nd draft, bring feedback and 2nd draft to regional HR network (operational level), SMT/Board sign off for consultation, 12-week public consultation, finalise policy, bring consultation report and final policy to regional HR network (operational level), approach HR Directors Forum and trade unions for endorsement, SMT/Board sign off. A second meeting took place on 26th September 2014 – policy redrafted to reflect considerable changes to the policy and procedure on the back of informed discussion from the first meeting. HR practitioners to feed in re potential impacts of the draft policy in relation to records management in particular when to change records to reflect newly acquired gender status and all others aspects of potential impact. The policy will require equality screening and public consultation as detailed above.

2015/16 Update:

A workshop was held on 2nd June 2015 amongst HR and Equality practitioners to discuss a number of outstanding issues ahead of consultation on the initial draft policy.

Following on from the June workshop invitations were cordially extended to Trade Unions and the Trans sector inviting them to attend one of three roundtable events in 2016. A further engagement event took place with the LGB&T staff forum for Health and Social Care on 3rd March 2016 in

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) UNISON HQ, Belfast.

The policy is aimed at creating a workplace where, first and foremost, the dignity of and respect for transgender people is protected and promoted and where transgender people feel comfortable to express their gender identity.

The policy will now be reviewed in light of feedback received from the focus groups and new research and guidance published in the past 12 months. Ultimately, the final draft will be submitted to the HR Directors Forum. Action 44: Development of a Develop Workplace Policy Launched. Year 1 – lifespan of HR Lead Vivienne Toal, EER New Local Action Domestic Violence Policy. current plan - 2014. Department (SHSCT), Workplace Policy Policy SHSCT - Health and  Need for Trust To raise awareness communicated Monitoring Wellbeing Group in Domestic of domestic abuse throughout the Arrangements - partnership with Trade Violence and offer support to Trust. Ongoing review of Unions. Workplace staff. policy and training Policy. Staff awareness evaluations. Establish domestic raising sessions. Source: HSC violence support Feedback from staff. Emerging Themes worker service. Specific training Document 2010 sessions for domestic violence Women’s Aid support workers.

UNISON Action 44 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

2015/16 Update:

Development of Domestic Violence Policy is ongoing in conjunction with the Trust’s Childrens and Young Peoples Directorate. Consideration is also being given to how designated staff, who will act as confidential Domestic Violence contacts for staff, can be nominated – when the draft policy is finalised. In addition the training requirements of these individuals/contacts will be considered and addressed. December 2015 is a more realistic time scale for completion of this work.

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) Action 45: Gender Equality – Greater uptake of Improved staff Ongoing – policy Human Resources - EER Ongoing Local Promotion of work life balance satisfaction. subject to review at Department and Equality Action Flexible Working provisions. least once every 3 Assurance Unit, SHSCT Practices years in line with  Men who FETO 1998. present as Promote work-life Reduction in staff Policy updated to unavailable for balance policies and absence. reflect legislative Monitoring work, only one procedures to enable developments and Arrangements - in twenty link staff to reconcile their Improved retention case law. Production of annual their situation work life rates. activity report showing to family or commitments. the uptake of work life home balance provisions. commitments. Promote the uptake In any of Employers for Monitoring of reasons comparable Childcare voucher for refusal. group of scheme. women that figure rises to Keep under review more than one Trust policy in light of in three. case law developments and  Childcare evolving legislative costs in NI are framework. approximately 44% of an average income, which is almost four times the EU figure of 12%

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As perviuously reported (2014/15) the Trust reviewed its Work Life Balance Policy to reflect the latest in legislative developments to enable staff to reconcile their work life balance commitments. This new legislative development came in the form of Shared Parental Leave and Pay. The Work and Families (Northern Ireland) Act 2015 which gave effect to this new legislative provision received royal assent on 8th January 2015 and came fully into force on 5th April 2015.

In summary, the Act sets out a legislative framework allowing for the voluntary sharing of leave and pay entitlement between parents following the birth or adoption of a child. The Trust has reviewed its current policy to take account of this new provision. Employers overall have seen very limited uptake of this relatively new provision.

2015/16 Update:

During the year under review the Trust developed an, ‘Other Leave Policy’ which will sit separately from the Trust’s Work Life Balance Provisions and will provide advice to managers on doctors/hospital appointments et al.

NB: The Trust continues to monitor the uptake of its WLB policy. Action 46: Promotion of an Greater choice and Greater uptake of Ongoing promotion Human Resources – EER Ongoing Local Age Friendly control for staff flexible retirement over the Life Span of Department and, Equality Action Workplace planning their policy options. the current Plan i.e. Assurance Unit, SHSCT retirement. 2014-17.  Age Friendly Promotion of Flexible Promotion of post Greater staff workplace. Retirement Policy: retirement options satisfaction. Monitoring e.g. bank working, Arrangements -  Trust age The Trust recognises volunteering etc. Improved health  S75 Annual profile as at 1st that many staff may and wellbeing. Progress April 2014 - wish to retire from Report. 46.7% of the Trust in a phased  Work Life

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Performance Indicator Timescale & Key Inequalities Description of Identified and Action Measure Lead Person Monitoring Source Outcome/Impact Output Arrangements (For S75 Groups) employees and managed way. Balance – were aged 45 Uptake/Activity and over. The Trust’s Flexible report. Retirement Policy aims to assist staff when planning and managing their retirement. Action 46 – Notes of Attainment: Action to Roll Forward to 2017/22 Equality Scheme Action Based Plan

Workage: Active Ageing Through Work Ability - Age Positive

Workage is a three year EU-funded project designed to test the proposition that the engagement and retention of staff aged 50+ will be improved by enhancing levels of involvement and participation in the workplace for all employees. The project aims to raise policymakers’ and employers’ awareness by demonstrating that targeted workplace interventions to improve job design and work organisation will facilitate enhanced engagement and retention of older workers. The research is predicated on the knowledge that some older workers start to lose enthusiasm for their job in their final years of employment and may even bring their retirement plans forward as a result. It aims to develop new strategies to help organisations re-engage with their older employees to the benefit of both the organisation and the individual. Workage is facilitating the transformation of work practices and cultures in two pilot sites: the maternity service in the Southern Health & Social Care Trust, Northern Ireland, and the Place Division, Stoke on Trent City Council, England. Interventions are focused on job design, self-organised teamworking, continuous improvement, high involvement innovation, workplace partnership and employee voice in strategic decision making. The carefully measured outcomes will be of considerable interest to policymakers, employers, trade unions, researchers and others across Europe with an interest in active ageing, employee engagement, workforce health and workplace innovation.

The Workage programme were delighted that SHSCT has chosen to participate in this project and are grateful for the commitment shown to date in making it a success.

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Appendix 2

PART B

Annual Report 1 April 2015 / 31 March 2016 ‘Disability Duties’

DISABILITY ACTION PLAN

 To promote positive attitudes towards disabled people

 To encourage the participation of disabled people in Public Life

The Disability Duties

Section 75 Action Based Plan – Appendix 2 – Page (1)

Part B – Section 49A of the Disability Discrimination Act 1995 (as amended) and Disability Actions Plans

1. Number of action measures for this reporting period that have been:

All fully Achieved bar 1 – See note on Self- 1 0 Directed Support – P38

Fully achieved Partially achieved Not achieved

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2. Please outline the following detail on all actions that have been fully achieved in the reporting period. 2 (a) Please highlight what public life measures have been achieved to encourage disabled people to participate in public life at National, Regional and Local levels: Level Public Life Action Measures Outputs1 Outcomes / Impact2 National3 Regional4 Development and roll out of The Trusts in Self Directed Support will Self Directed Support partnership with the offer more control, flexibility arrangements which will Health and and independence to people come into effect from June Social Care Board as they choose the support 2015. (HSCB) are introducing they want. a new way of delivering Social Care Services Self Directed Support called Self Directed enables people to choose Support. how their support is provided and gives them This system will provide more control over their more choice and personal budget. flexibility for eligible individuals enabling Self Directed Support them to tailor a care enables people to have package that best suits more flexibility, choice and their needs. control over the support they

1 Outputs – defined as act of producing, amount of something produced over a period, processes undertaken to implement the action measure e.g. Undertook 10 training sessions with 100 people at customer service level. 2 Outcome / Impact – what specifically and tangibly has changed in making progress towards the duties? What impact can directly be attributed to taking this action? Indicate the results of undertaking this action e.g. Evaluation indicating a tangible shift in attitudes before and after training. 3 National : Situations where people can influence policy at a high impact level e.g. Public Appointments 4 Regional: Situations where people can influence policy decision making at a middle impact level

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Consultation on an receive, such as: EQIA was commenced • Employing their own by the HSCB and personal assistant concluded in May 2015. • Having support staff visit at Trusts facilitated a time that they choose consultation events in • Flexible options for short each of their areas on breaks Self Directed Support • Accessing community and staff training has opportunities. commenced on the proposed changes. NB: Self Directed Support does not replace traditional services and people can continue with their existing package.

The 5 Trusts have adopted a phased approach to the implementation of Self Directed Support. It is planned that by end March 2019 Self Directed Support will be mainstreamed across all programmes of care within each Trust. Self Directed Support NI development takes cognisance of the learning from across the UK and contacts are maintained with

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some Local Authorities in England. The Self Directed Support initiative introduces a co-production approach with service users and carers as equal partners in developing their support plans following assessment of need. This approach by nature is person-centred and training is currently being rolled out across the 5 Trusts over 3 levels with level 3 covering assessment and individual support planning.

In addition to the 26 service users using Self Directed Support from the Southern Trust’s initial phase of implementation, a further 3 are in operation with 15 in process. Self Directed Support is now available to carers and there are currently 4 carers using Self Directed Support with a further 12 in process.

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Local5 Continued roll out of Involving Launch of PPI Greater participation of You - the Public and Personal Standards in March disabled persons in public Involvement (PPI) Strategy 2015. life - increased involvement 2012-2015. in planning and decision Updated Consultation making processes of the Scheme. Trust.

Provision of PPI Toolkit Involvement of S75 groups and staff training. at all 5 levels of personal and public involvement to Development of ensure inclusiveness and Guidance on how to representativeness. target hard to reach Service User Panel / User groups. Groups are more

representative of S75 Targeted consultation groups. sessions with Disabled

People/Groups e.g. Self Recognition of contributions Directed Support. made by disability sector

and individuals. PPI Roadshow to raise

awareness of how Staff more experience in people can become consultation/engagement involved - showcased methods. involvement work to

5 Local : Situations where people can influence policy decision making at lower impact level e.g. one off consultations, local fora.

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date and promoted Continued facilitation of opportunities for further service user and carer led involvement. PPI Panel. Development of The Public Health Agency Advocacy Information Evaluation Report booklet. concluded that: On the basis of the evidence Development and provided, the SHSCT are implementation of the most advanced Trust in Annual Directorate PPI relation to complying with Action Plans which the Statutory Duty of include specific action Involvement and measures. Consultation. PPI is clearly on the agenda of the senior management team and widely embedded within policy and practice in the organisation. The Trust has demonstrated leadership and has regularly shared good practice in this field across the HSC system. The strength of their commitment to service user and carer involvement has been demonstrated through its structures, through its monitoring and reporting arrangements and through the production of a wide

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range of support and guidance materials for staff and service users.

The Trust has undertaken its own self-audit checklist exercise to determine the level of compliance with its PPI Indicators. The focus in going forward will be to update the Trust’s PPI Strategy; the PPI toolkit; HSC Consultation Scheme – Flowchart; the provision of practical support to further mainstream the Trust’s PPI obligations across the Trust’s Directorates, together with the provision of staff training. These activities will be picked up and reflected in the Trust’s new Equality Scheme Action Based Plan covering the period 2017-2022. For details of further achievements see notes of attainment – Appendix 1 – Action 18 refers.

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2(b) What training action measures were achieved in this reporting period?

Training Action Measures Outputs Outcome / Impact 1 Delivery of Equality and On-going training events On-going mainstreaming of the disability Human Rights Screening held during the current duties into screening and EQIA Master Classes – reporting period which processes and policy developments e.g. incorporating the incorporated the disability EQIA on the Future Proposal for Stroke Disability Duties. duties and training on Services, Dementia and Hospital Based disability equality. Services for Older People, Proposal for the Future of Statutory Residential Care Provision of on-going advice for Older People. and support provided by Alignment of the Trust’s Equality Scheme Equality Managers to policy with the Trust's corporate planning cycle authors on the application of to further facilitate the mainstreaming of S75 equality and disability the S75 equality and disability duties. duties. Incorporation of S75 equality and disability duties in the Trust’s new Specific guidelines for Trust Strategic Plan. Board members have been Top level commitment to ensure the devised to highlight the effective mainstreaming of the S75 importance of mainstreaming equality and disability duties. the S75 equality and S75 cumulative assessment of the disability duties into the day Trust’s 2015/16 Financial Plan as well as to day business functions of the completion of individual equality the Trust including policy screening and where necessary and development, the design and appropriate full EQIAs e.g. Proposal for delivery of services and the Future of Statutory Residential Care decision making processes. for Older People, Self Directed Support and consultation and EQIA on the development of Ophthalmic Clinic

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Centres in NI Southern and South Eastern Local Commissioning Group/Trust Areas. See also the Trust’s quarterly screening outcome reports for further evidence of compliance with the S75 equality duties together with this year’s S75 annual progress report to the ECNI. Other notable equality screenings and consultation include the Trust’s Strategy Plan – Improving Through Change and the consultation on the proposed permanent closure of Armagh Minor Injuries Unit.

Guidelines for Trust Board members will be reviewed to take into account any changes to the consultation timeframes as a consequence of the Fresh Start Agreement. The Trust provided a considered response to the ECNI during the current reporting period May 2016. This will be taken forward as part of the planning around new Equality Scheme - Action Based Plans covering the period 2017-2022. 2 Continued roll out of Increase uptake of these Promotion of positive attitudes toward Discovering Diversity – training modules by Trust disabled persons. E-learning modules staff – 1741 staff have Improved patient experience as a which includes module 4 completed these consequence of increasing awareness on the Disability Duties. programmes to date. and promoting positive attitudes.

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. Periodic reminders are Sharing of good practice. HSC Trusts issued to staff from the are working toward augmenting the Directorate of Human regional e-learning package to Resources to complete each incorporate further information on a of these modules in human rights based approach to Health fulfilment of the Knowledge and Social Care and convention rights and Skills Framework (KSF). such as the UN Convention of the Rights of Persons with a Disability. Quarterly monitoring of uptake of e-learning programme and annual reporting through e.g. S75 Annual Progress Report.

Development of 2 new e- To address any knowledge Promotion of positive attitudes towards learning modules for staff gaps i.e. S75 Equality disabled persons. and managers Duties, Good Relations, Sharing of good practice across the Human Rights and Disability region. Duties. Improved patient and staff experience.

To be launched autumn 2016. 3 Delivery of Human Rights Human Rights, DOL's Promotes positive attitudes toward Face to Face Training – Capacity, Care Planning & disabled persons. Further raises incorporating Disability Recording: 04/11/2015 – 15; awareness of the Disability Duties Duties. Human Rights Training amongst HSC staff. Improves staff/ 25/1/16 – 22; Human Rights patient experience. Training 28/1/16 – 18; Human Rights Training 12/2/16 – 20.

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4 Delivery of Training and In-house PPI Awareness Increase awareness and understanding Resources to ensure the training continues to be of PPI among staff, service users, carers effective implementation delivered at Team level and and the public. of PPI as part of the core induction programme for Social Work Involvement of disabled persons in PPI students twice yearly. The and decision making processes of the training was revised in May Trust. 2015. There follows summary Inclusive and meaningful engagement of details of the level of PPI disabled persons. awareness training delivered during the current reporting Increased participation of disabled period: persons in public life activities.  PPI Awareness Compliance with Regional Training delivered to student Programme. social workers at core induction programme August 2015 and Jan 16. 71 students and 30 new staff members and at team meetings to existing staff:  15/04/15 Brain Injury team – 6  13/06/15 QUF Physio Assistants – 8  15/06/15 Community Midwives – 10 Resources developed to facilitate the  28/06/15 Children’s mainstreaming of PPI.

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Development clinic staff – 12  15/09/15 Professional Development Prog For Nurses & Midwives – 11  25/01/16 School Nurses Speakers Meeting - 30  Leadership Within -2 workshops 54 staff OPPC Sept 15  CIT – Quality Improvement E learning pilot (PPI section) 30 staff  How to involve service users and carers workshop x2 (43 staff) at Quality Improvement Event 14/10/15  Regional PPI Awareness E learning pilot Oct 2015 9 staff and 4 Panel members  Engage and Involve – PPI Coaching pilot – Capacity building and increased user 11 staff- T4T – 4 staff involvement activity.  Mental Health Core Care Pathway staff

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awareness sessions co-developed with UCSIG. 100+ staff trained.

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from the Trust have participated in the Representation from a wider range of development of the regional S75 groups and individuals. PPI training strategy and pilot training programme development. The e-learning module is now being revised by the PHA to ensure that it is in line with the new regional training programme and is now available to staff with effect from July 2015. A range of resources have also been developed to assist with raising awareness of PPI organisational and individual responsibilities amongst staff and to support staff and service users and carers in implementing PPI effectively. Such measures include: A Directorate Action Plan template to focus staff along the following key themes:  Information  Service User and Carer Involvement  Evidencing Patient &

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Client Experience Standards  Training  Monitoring and Extending good practice regionally. Evaluation. PPI indicators have been developed for each of the above 5 key themes. A PPI Staff Toolkit has also been developed to provide staff and managers with information and good practice guidance to enhance personal and public involvement within their service area. The toolkit brings together a range of resources to support the delivery of the PPI Operational Action Plans. Hard copies of the toolkit have been disseminated to all managers across the Trust and is also available on the Trust's Intranet under the ‘Promoting Wellbeing’ section. The toolkit has been shared with other HSC organisations through the Regional PPI Forum in the

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interest of extending good practice. It has also been used as a resource in the Public Health Agency PPI Training Programme. In addition, ‘Have Your Say’ posters and leaflets have been produced and disseminated so that staff, service users and carers are aware of their right to be involved. Registration forms have also been drawn up and shared with service teams to facilitate teams in developing their own local lists of interested people for PPI purposes. Further, an opportunity for involvement template has been developed so that service teams can let their service users and carers know what opportunities are available for them to become involved. Good practice guidelines for engagement i.e. an “INCLUSIVE” poster has been drawn up and issued to

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staff to complement the PPI Toolkit. A range of factsheets to complement the toolkit have also been made available to staff including - Facilitating Focus Groups; How to set up a Service User Group; Methods of Involvement; What is PPI?; Questionnaire design (including standard questionnaire template); Working with Hard to Reach Groups – which has been picked up by the Equality Commission for NI as an example of good practice; and most recently an Advocacy Information Booklet has been produced so that staff and service users and carers are aware of the benefits of advocacy. A PPI Checklist exercise was undertaken to gauge compliance across POCs with the PPI indicators – during the year under review. The outcome report that is currently being

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developed will inform the Trust’s PPI Action Plans for 16/17. The focus in going forward will be to update the Trust’s PPI Strategy, the PPI toolkit, HSC Consultation Scheme - Flowchart, the provision of practical support to further mainstream the Trust’s PPI obligations across the Trust’s Directorates, together with the provision of staff Training. These activities will be picked up and reflected in the Trust’s new Equality Scheme Action Based Plan covering the period 2017-2022. 5 Developing Cultural Following on from the roll out Access to culturally competent services Competence – HSC Staff of training for HSC staff that are responsive to individual needs of Resources. working in Mental Health BME service users who require support Services further train the from Mental Health Services. trainers sessions were held, during the current reporting period, to train up staff so that they are self-sufficient to deliver these sessions in the future and in order to ensure the sustainability of this

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programme.

To support the training Provision of Mental Health Services sessions and the roll out of which take into account different cultural the toolkit a cultural needs and experiences. competency DVD has also been produced.

Arising out of recent Improved coordination of professional research entitled ‘Walking health services with BME community this thin line’ Black and groups in order to increase BME Minority Ethnic (BME) communities general sense of Experiences of Mental accessibility of Mental Health Services Health & Wellbeing in N. Ireland. Katy Radford, Brendan Sturgeon, Isabella Earlier engagement with Mental Health Cuomo and Olivia Lucas professionals before crisis intervention. Institute for Conflict Research - December 2015 a pilot training programme will be developed which will Greater awareness and reduce stigma incorporate the impact on amongst BME communities re Mental BME individuals of both the Health services. stigma around mental health as well as highlighting the challenges of help-seeking and cultural beliefs into an Improved health and wellbeing outcomes educational and training for BME communities. resource for service

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providers. This will be picked up in the Trust’s new Equality Scheme Action Based Plan covering the period 2017-2022.

6 Staff Training – Mental Awareness sessions Training will assist staff to more fully Capacity Legislation delivered to 40 staff appreciate the principles of the Also individual engagement legislation and translate into practice. with relevant staff. Positive impact on individuals with a Mental Health condition. 7. Production of Information Production of staff Greater staff awareness of the on UNCRPD information leaflet on importance of Human Rights and UNCRPD. Disability considerations across service Leaflet launched in early provision and policy development. autumn 2015 at the Regional Physical and Sensory Disability Workshop, disseminated to HSC staff and available on the Trust intranet. 8 Delivery of Visual Provision of Visual Greater staff awareness of the needs of Awareness Training and Awareness Training in service users and staff with sight loss. Guiding Techniques collaboration with RNIB NI to (VAT) support Trust staff working Greater understanding of the DDA and with people with sight loss. Trust’s statutory obligations. The course covers communication skills, Improved patient/staff experiences. guiding skills, guide dogs,

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the Disability Discrimination Act and group work and group work scenarios. 24 awareness sessions were delivered to 171 individuals. These sessions had a large impact on participants which benefited service users. 9 Sensory E-learning Delivery of staff training to Greater staff awareness of the needs of Training Programme raise awareness of the patients/clients/staff with sensory loss. needs of service users and staff with sensory loss.

As part of the on-going work Better patient/client/staff experience. of the Regional Physical and Sensory Disability Strategy, a Sensory E-learning training programme has been developed by the Leadership Centre. Various staff from the SHSCT (Collette Bigley, Hearing Disability Services Manager, Ray Maxwell, Sensory Disability Team and Frances Steenson, Social Worker) participated in the pilot training to help shape and inform the final content. This programme is widely available to HSC staff.

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Further, a Good Practice Guidance Checklist has been drafted to ensure the needs of people with disabilities are considered in the design and development of health promotion programmes/campaigns.

A regional deafblind needs analysis report was completed and key findings of this review were launched at a workshop in autumn 2015. Specialist deafblind training for HSC staff commenced in September 2015.

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10 Development of Training Review of Disability Etiquette Increased staff understanding and Resources – Disability Booklet in partnership with competency in communicating Etiquette booklet the Disability Sector. effectively with people with a wide range of disabilities.

Updated guidelines on good practice and minimum standards available to all Trust staff includes Autism - The Autism Act (NI) 2011 amended the DDA (Disability Discrimination Act 1995) to remove any ambiguity as to whether the term “disability” applies to autism spectrum conditions Staff compliance with best practice standards.

Improved patient/client/staff experience.

11 Staff Forum Staff Forum established and Improved policy development. terms of referenced agreed. Greater staff awareness of the DDA - the Production of Trust staff disability duties. information sheet – aimed at promoting a positive and An inclusive workplace that supports the supportive culture toward needs of staff with a disability. persons with a disability. 12 Continued roll out of the The Butterfly Scheme has The Butterfly scheme - allows people Butterfly Scheme which been incorporated into a whose memory is permanently affected aims to improve the Trust-wide dementia strategy by dementia to make this clear to experience of people with along with staff training. hospital staff and provides a simple, memory impairment who practical strategy for meeting their are admitted to hospital This scheme is being rolled needs. It also incorporates a system for

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out in acute and non-acute offering that same response to people hospitals in the Southern with temporary confusion. Trust. The patients receive more effective and In terms of staff training the appropriate care, reducing their stress hospitals have identified levels and increasing their safety and champions from Nursing, well-being. Medical, AHP, Domestic, Equips staff to more effectively meet the Portering, Radiology, needs of these patients and increases phlebotomy to attend training the well-being and safety of people with sessions. The Butterfly memory impairment whilst they are in Trainer and 2 carers will hospital deliver rolling 45 min sessions for ALL grades of staff to attend; staff will then confirm their learning by completing e certification. To compliment this scheme the hospitals are also delivering Patient Safety Briefing sessions, implementing Delirium Screening and are now Dementia Friendly Environments.

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13 All Trusts should have in In response to the Appropriate terminology included in place clear accountable publication of the GAIN historic link nurse training and included in process for the guidelines a small project LD awareness training implementation and team was established to Agreed to commission further LD review of GAIN ensure this work was given awareness training for staff to be taken guidelines. priority. forward by Acute Project Lead nurse with support from improvement lead All Trusts should ensure Acute Service Improvement that appropriate Leads has been identified as terminology is used in the the Acute/Hospital for the context of learning Regional Learning Disability disability Hospital Care in association with RQIA.

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2(c) What Positive attitudes action measures in the area of Communications were achieved in this reporting period?

Communications Action Outputs Outcome / Impact Measures 1 Review of Accessible This updated resource addresses Greater staff expertise in the Communication communication barriers and gives provision of effective communication Guidance for HSC staff tips and advice to enhance for individuals with a range of (completed in February effective communication. The disabilities. 2015.) Re-launched Review involved stakeholder input. 27th June 2016 in collaboration with the The Guide assists staff to ensure ECNI. that people get the support with communication that they required Improved patient experience. e.g. through the provision of sign language interpreters.

The scoping out of Easy Read Trust information more accessible options via Social Enterprise for all users e.g. through the models and Regional work to increased use of Easy Read develop a list of providers of documents. accessible formats for people with disabilities.

Increased amount of Trust information produced in alternative Improved patient experience and formats e.g. Easy Read, larger clear guidelines for staff. print, use of sign language interpreters, subtitles and sign language on the production of

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DVDs.

Information circulated via Trust’s Raising staff awareness of Autism. intranet on events to mark Autism Awareness month in April 2015

Production of Autism fact sheet for staff.

Development of an Assistance Dog Policy in 2015. 2 Continue participation Cross Departmental work including A regional deafblind needs analysis on the Regional HSC Board, PHA, Trusts, DEL, report has been produced with key Physical, Sensory and DSD, voluntary organisations and recommendations. Disability Strategy service users. Implementation Group Self-directed support programme Action to address inequalities and launched 2014/15 to make sure identify gaps in service provision. individuals and their families have greater control and more flexibility over a personal budget. It includes Good Practice Guidance Checklist a number of options for getting to ensure the needs of people with support. disabilities are considered in the design and development of health The Accessible Formats policy and promotion programmes/ guidance has been issued to HSC campaigns. organisations through the Regional Accessible Formats Steering Group for implementation. Greater staff expertise in this area. Improvements in health and

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wellbeing for people with disabilities. 3 Steps taken to Staff within the Day Procedure Unit Service provided in an environment accommodate patients (DPU) in the Southern Trust have that meets the needs of patients with Learning Disability implemented creative approaches with a LD. in the Day Procedure to accommodate the needs and Unit wishes of their patients with a Family and carer involvement to Learning Disability (LD) and their obtain vital information on how to families/carers when they require approach the patient – likes and dental treatment under dislikes. anaesthesia Communication and information needs taken into account on an individual basis. 4 Hospital Resources Provision of Easy Read leaflets Communication and information Developed for Patients utilising appropriate terminology needs taken into account on an with a Learning are in place. individual basis – greater use of Disability Each ward has a resource folder easy read materials. containing all easy read leaflets All Trusts should have in that are available, guidance and Service provided in a conducive place clear accountable contact numbers. The Trusts LD environment that meets the needs process for the working groups developed all of patients with a LD. implementation and literature in use with the patient review of GAIN support staff and PPI team. Improvements in patient experience guidelines. Production of Practical Guide for HSC Practitioners to effectively All Trusts should ensure meet the needs of patients with a that appropriate LD. terminology is used in the context of learning About Me – I like to me know as –

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disability records information about the individual person and their communication needs as well as other important information.

Greater use of easy read:

The Hospital Communication Booklet – use of photos, pictures and signs

Visual Menu – photos and sign Tell Us What you think Leaflet – pictorial and signage Weight Management Having an x-ray Blood Test Your visit to theatre CT Scan MRI Scan Tooth extraction

Posters at ward level: A Learning Disability is? The Health Care Visit Techniques to use with people with a disability.

5 Carers’ Programme Trust staff are working in Accessible services for families, aimed at supporting partnership with colleagues in the carers and parents of young people

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families with children voluntary sector e.g. YMCA to help with Autism. who have autism. provide a wide range of support services and information to families, carer`s and parents of young people with Autism. 6 Mental Health Forum The Mental Health Forum Website Facilitates the exchange of Website has been built by, and continues to information, promotes good mental be run by, mental health service health and reinforces the recovery The Mental Health users of the Southern Trust and message. Forum is The Voice of functions as a crucial information Service Users across hub. It offers clients easy access to a mental health services (www.thementalhealthforum.co.uk). wealth of information and support in the Southern Trust. resources including up to date links to literature available within services – all in one convenient place. Valuable community support and wellbeing links are listed alongside helpline and support contact info for a wide range of organisations.

Opportunities for service users to become involved in Trust activities are regularly posted on this website. 7 Recovery Stories Book The Recovery Stories Book has A Recovery Story Booklet has been – ‘Recovery, My Life … been co-produced by people with produced as an insight into the lived My Way Forward’ lived experiences of mental health experience of recovery for those difficulties, those who support them who use services and their carers. The pieces of work are and the people who work in Mental expressions of an inner Health Services in the Southern The staff perspective has also been journey for people who Trust area. A range of people were really useful as there is an

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have mental health asked to contribute their stories or increasing awareness of allowing difficulties. indeed any piece of work that people who have challenges and demonstrated their own personal difficulties to take back control of journey. their lives so that they can live a more meaningful and rewarding life. 8 Roll out of Complaints Use of alternative formats to Greater accessibility for persons DVD facilitate access to the HSC with a disability to access the HSC complaints procedure. complaints procedure.

Improvements in patient experience and outcomes for service users and members of the public.

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2 (d) What action measures were achieved to ‘encourage others’ to promote the two duties:

Encourage others Action Outputs Outcome / Impact Measures 1 Provision of placements Provision of meaningful Greater participation of disabled aimed at increasing work placement opportunities for persons in public life and promotion of place opportunities for persons with a disability. positive attitudes toward disabled people with a disability. To date the Trust has persons. exceeded the target of 7 placements in this reporting Enhancing employment skills / period through the Placement opportunities for participants. Policy disability scheme a bridge to employment.

NB: This figure does not include placements offered to schools and colleges nor opportunities via the Trust’s volunteering scheme nor schemes such as Steps to Work nor the Young Persons Employability Scheme. 2 Continued Provision of 2428 staff attended Promotes a more inclusive workplace. Reasonable Adjustments Occupational Health in the Greater retention of staff within the for staff. period 1st April 2014 – 31st workplace. March 2015 as a result of management referrals. Improvements to the health and Approximately half of these wellbeing of staff. referrals had reasonable adjustments recommended Good staff morale.

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including e.g. phased return to work to assist staff back to work after a period of long term absence, flexible/reduced hours, temporary adjusted duties.

In practice many reasonable adjustments are instigated at local level by Line Managers in line with the Work life Balance Policy. 3 Roll out of HRPTS Promotes a more supportive Fosters a culture where staff feel Employee Self-Service work place environment. comfortable and supported to self- function in relation to declare that they have a disability in Equality Monitoring which More accurate, real time base accordance with the DDA definition of incorporates disability line data on the prevalence of disability. considerations disability amongst staff. Improvements to the health and wellbeing of staff - provision of timely reasonable adjustments.

Further mainstreaming of the disability duties - equality screenings and EQIAs taken into account in decision making processes. 4 Recruitment measures to 4 Peer Support Workers have A key element of the IMROC/Recovery attract individuals with life been appointed - 2 service Programme. experiences of Mental users were trained to sit on the Health panels for these posts. Enhanced employment opportunities

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Regional Activity – Staff with lived experience of mental Representatives of the health have had a positive impact for Regional Resourcing service users in terms of greater Managers Network group were empathy and understanding. also asked by HR Directors to meet with the Patient Client Council to discuss service user involvement. This took place in February 2015. An action plan has been discussed with HR Directors which would aim to have some level of involvement of service users in the process design.

In addition, the involvement of a service user on a panel for a Band 7 Recovery Co-ordinator post was agreed. This is a specific arrangement due to the nature of the work and the specific programme concerned i.e. the IMROC/Recovery Programme. Training took place in August 2015 and interviews were held in September 2015.

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2 (e) Please outline any additional action measures that were fully achieved other than those listed in the tables above:

Action Measures fully Outputs Outcomes / Impact implemented (other than Training and specific public life measures) 1

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3. Please outline what action measures have been partly achieved as follows:

Action Measures partly Milestones6 / Outcomes/Impacts Reasons not fully achieved Outputs achieved 1 EQIA completed Individuals will have Consultation ended Self-Directed Support (SDS) Consultation greater choice over May 2015. SDS will completed their care and not be rolled out to greater the Trust until June independence. 2015.

The SDS initiative The 5 Trusts have introduces a co- adopted a phased production approach to the approach with implementation of service users and SDS. It is planned carers as equal that by end March partners in 2019 SDS will be developing their mainstreamed across support plans all programmes of following care within each Trust assessment of need.

In addition to the 26 service users using SDS from the Southern Trust’s initial phase of

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implementation a further 3 are in operation with 15 in process. SDS is now available to carers and there are currently 4 carers using SDS with a further 12 in process. 2 3 4

4. Please outline what action measures have not been achieved and the reasons why?

Action Measures not met Reasons 1 2 3

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5. What monitoring tools have been put in place to evaluate the degree to which actions have been effective / develop new opportunities for action?

Action measures in the DAP will be subject to on-going monitoring and review. Progress on the implementation of the DAP is monitored on a 6-8 weekly basis at the Regional Equality Leads meeting. Progress will continue to be recorded in the Trust’s Annual S75 Progress Report to the ECNI.

(a) Qualitative:

PPI Initiatives and Consultation Processes and Outcomes; Feedback from Service Users; Update of Themed Inequalities Audit; Review of complaints/compliments.

(b) Quantitative:

Performance Indicators in DAP; Update of Themed Inequalities Audit; Consultations on specific areas e.g. Self Directed Support; New Carers Contract, Carers Forum, Mental Health Forum, etc; HRPTS – Employee Self Service – more accurate and up-to-date staff data on S75 characteristics; 2011 Census data – utilisation in Screening and EQIA processes. Screening and EQIA Processes; Quarterly Screening Outcome Reports;

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6. As a result of monitoring progress against actions has your organisation either:

. made any revisions to your plan during the reporting period or No . taken any additional steps to meet the disability duties which were not outlined in your original disability action plan / any other changes?

Please delete: No

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If yes please outline below:

Revised/Additional Action Measures Performance Indicator Timescale 1

7. Do you intend to make any further revisions to your plan in light of your organisation’s annual review of the plan? If so, please outline proposed changes?

______

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